摘要
目的随访Bernese骨盆三联截骨术治疗大龄发育性髋关节脱位（DDH）以及DDH残留畸形的短期临床效果。方法2010年11月至2011年11月采用Bernese三联截骨治疗DDH29例（33髋）。其中11例（13髋）为大龄DDH，未曾接受任何治疗，男5例，女6例，年龄7～15岁，平均11．2岁；按照Tonnis分级标准，I级8髋、Ⅱ级2髋、Ⅲ级2髋、Ⅳ级1髋。18例（20髋）为DDH治疗后残留畸形，男3例，女15例，年龄3～16岁，平均7．3岁；11例（13髋）曾行保守治疗（石膏／支架），7例（7髋）曾行切开复位＋骨盆截骨／股骨截骨术；按照Tonnis分级标准，I级15髋、Ⅱ级5髋，其中7髋合并股骨头坏死。结果26例（30髋）获得随访，随访时间7～20个月，平均14个月，按照McK—ay评分标准，髋关节功能优17髋、良9髋、中1髋、差3髋。按照Severin评分标准，x线片结果优15髋、良12髋、差3髋。臼头指数术前平均（44±21）％，术后较术前升高，为平均（85±22）％，差异有统计学意义（t=7．053，P〈O．00）。结论Bernese骨盆三联截骨术治疗大龄DDH及DDH残留畸形短期临床效果良好。
Objective To present short-term outcome of Bernese triple osteotomy of the pelvis for developmental dysplasia of the hip （DDH） in elder children and residual hip deformity after previ- ous surgery. Methods From November 2010 to November 2011, 33 hips of 29 children underwent Bernese triple osteotomy in this institute. Eleven cases （13 hips） were elder DDH without any previ- ous treatment. The patients included 5 males and 6 females, with a mean age of 11.2 years old （range, 7-15 years old）. According to the Tonnis grading standard, 8 hips were grade I DDH, 2 were grade [[ , 2 were grade I]I, and 1 was grade IV. Another 20 hips of 18 patients were residual hip deformity. There were 3 males and 15 females with an average age of 7. 3 years old （range, 3-16 years old）. Eleven children （13 hips） were treated conservatively. Seven children （7 hips） underwent open reduction with pelvic and femoral osteotomy. According to the Tonnis grading standard, 15 hips were grade I DDH, and 5 were grade H. Seven hips were diagnosed with avascular necrosis of the femoral head during follow-up. Results Twenty-six patients （30 hips） were followed up for an average time of 14 （7-20） months. Hips＂ function was judged by the Mckay criteria, 17 hips were excellent, 9 were good, 1 was fair, and 3 were poor. The alignment of joint was evaluated on X-radiography according to Severin classification, 15 hips were excellent, 12 were fair, and 3 were poor. The preoperative ace- tabular head index was 44 ＋ 21 %, which was significantly improved to 85 ＋ 22 % after surgery （P〈 0. 05）. Conclusions The short-term outcome of Bernese triple osteotomy of the pelvis is satisfactory for the treatment of DDH in elder children and residual deformity.
出处
《中华小儿外科杂志》
CSCD
北大核心
2013年第4期286-289,共4页
Chinese Journal of Pediatric Surgery
基金
山东省科学技术发展计划（2007GG10002015）
关键词
发育性髋关节脱位
截骨术
股骨头坏死
Developmental dysplasia of the hip
Osteotomy
Femur head necrosis
