摘要
[目的]介绍一种Chiari截骨、植骨加盖螺钉固定术治疗各种原因引起的髋臼发育不良。[方法]从1982年10月～2001年10月在吉林大学第一医院骨科共有63髋（56例患者）因髋臼发育不良而行Chiari截骨、植骨加盖螺钉固定术。患者年龄为8～42岁，平均20．7岁。术前X线片显示WibergCE角平均4°，髋臼覆盖率平均60％，Sharp角平均51°，髋臼角平均为27°，除2例外均有不同程度的半脱位（Shenton线不连续）。[结果]37髋（32例患者）有6个月～8年的随访结果，平均45个月，其中30髋疼痛明显改善，术后x线片显示WibergCE角平均44°，Sharp角平均37°，髋臼角平均12°。Harris评分从术前平均76．3分，提高到术后平均89分。术后并发症包括2髋骨块被吸收。[结论]Chiari截骨、植骨加盖螺钉固定术较适合治疗各种原因引起的髋臼发育不良。
[ Objective] To introduce the Chiari osteotomy combined with bone grafting shelf procedure and scew fixation for the treatment of acetabular dysplasia which was caused by all sorts of reasons. [ Methods ] Totally 56 patients （63 hips） with acetabular dysplasia were operated by Chiari ostentomy combined with bone grafting procedure and screw fixation from Octobor 1982 to October 2001, the average age of the patients was 20. 7 years （8 -42 years）. There were 7 males who didn＇t have acetabular dysplasia of both hips, 49 females in which 7 ones had acetabular dysplasia of both hips. The X-ray graphies before operation showed： average CE angle was 4° （ - 20° - 18°） , femoral head coveragement ratio was 60% （42% - 75% ）. Sharp angle was 51° （40° - 58° ）, AC angle was 27 ° （20° - 38° ）. All of the patients had subluxation of hip （ broken Shentions line） of different degrees except two. [ Results ] Thirty-two patients （37 hips） had followed up results for average 45 months （6 months to 8 years）. Thirty hips were obviously pain-free. The average CE angle was 44° （41° -62°）, Shape angle was 37° （30° -45°） AC angle was 12° （8° - 18°） , Harris hip score was increased from 76. 3 （61 -82） before operation to 89 （76 - 95 ） after operation. Two hips had the complication of bone absorbtion after operation. [ Conclusion ] The Chiari osteotomy combined with bone grafting shelf procedure and stew fixation is a better procedure for the treatment of acetabular dysplasia, the main advantages of it are as following： （ 1 ） The injury during the operation is light without much blood lost, blood tranfusion is not needed. （2） It has the merits of Chiari osteotomy. （ 3 ） It can increase the femoral head coveragemean efficiently. The diameter of acetabular from anterior to posterior and the diameter form left to right can be increased. （4） It is not easy for the bone grafted to the absorbed. （5） It works in the case which can＇t be absolved by
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2008年第3期169-171,共3页
Orthopedic Journal of China
