摘要
目的总结关节镜辅助手术治疗发育性髋关节脱位（developmental dislocation of the hip,DDH）患儿的中期疗效。方法回顾分析2007年5月至2009年5月,采用关节镜辅助手术技术治疗18例（24髋）DDH,其中男4例,女14例;年龄9-16个月,平均13.6个月;左侧9髋,右侧15髋;双侧6例,单侧12髋。所有患者在决定手术前,全麻下闭合复位均失败。结果 18例切口均1期愈合,术后获随访5-7年,平均6.5年;手术时间35-56 min平均42.5 min;石膏固定24-36周,平均31.2周。随访期间,所有患者均获正常步态和髋关节活动度。术前所有患者X线片显示Shenton线不连续,术后均明显改善,并恢复连续性。患者平均髋臼指数由术前平均40.1°（33.0-52.0）°改善至术后25.8°（21.0-34.0）°（P=0.000）。术后所有患者均恢复股骨头和髋臼同心圆匹配。随访期间1例继发髋臼发育不良,随后行Salter骨盆截骨术治疗。结论对于闭合复位失败的DDH患儿,采用关节镜辅助手术治疗,安全有效、中期疗效满意。
Objective To summarize the intermediate-term clinical outcomes of arthroscopic-assisted surgical treatment for developmental dislocation of the hip（ DDH） in children.Methods A retrospective analysis was performed based on the clinical data of 18 patients（ 24 hips） who underwent arthroscopic-assisted surgical treatment from May 2007 to May 2009.There were 4 males and 14 females,whose average age was 13.6 months（ range：9-16 months）.There were 9 left hips and 15 right hips,and bilateral DDH was found in 6 patients and unilateral DDH in 12 patients.Closed reduction failed in all the patients under general anesthesia before the operation was decided.Results All the incisions healed by the first intention.All the patients were followed up for a mean period of 6.5 years（ range：5-7 years）.The mean duration of surgery was 42.5 min（ range：35-56 min）.Plaster immobilization was used for a mean duration of 31.2 weeks（ range：24-36 weeks） postoperatively.During the follow-up,all the patients had a normal gait and full range of motion（ ROM） of the hip.According to the preoperative radiographic examination,the Shenton＇s line was discontinuous,which became normal in all the patients postoperatively.The mean preoperative acetabular index was improved from 40.1°（ range：33.0°-52.0°） to 25.8° from（ range：21.0°-34.0°） postoperatively（ P=0.000）.The concentric circles of the femoral head and the acetabulum were matched in all the patients postoperativly.During the follow-up,secondary acetabular dysplasia was found in 1 patient,who was treated by Salter innominate osteotomy later.Conclusions The arthroscopic-assisted surgical treatment of failed closed reduction in the children with DDH is safe and effective,with satisfactory intermediate-term clinical outcomes.
出处
《中国骨与关节杂志》
CAS
2015年第7期557-560,共4页
Chinese Journal of Bone and Joint
关键词
髋关节
髋脱位
先天性
关节疾病
关节镜检查
矫形外科学
发育性髋关节脱位
Hip joint
Hip dislocation
congenital
Joint disease
Arthroscopy
Orthopedics
Developmental dislocation of the hip（DDH）
