髋脱位_____髋脱位；_再脱位；_联合截骨；

联合截骨治疗大龄儿童髋关节脱位手术后再脱位

http://www.100md.com 《中国矫形外科杂志》 2005年第21期

髋脱位,,髋脱位；,再脱位；,联合截骨；,大年龄儿童,1资料和方法,2结果,3讨论,参考文献：

     摘要：[目的]讨论大年龄儿童髋关节脱位手术后再次脱位手术治疗的意义和方法。[方法]通过对9例大年龄儿童髋关节脱位手术后再脱位，采用Pemberton手术+改良沙氏+股骨上段截骨术的联合截骨治疗，进一步阐明再脱位的原因及预防措施。[结果]随访时间1～9 a，优5髋(5/9)，良3髋(3/9)，1例术后髋关节外展受限，关节轻度强直(1/9)。髋臼指数由手术前的31～43°(平均325°)减少到手术后的5～19°(平均112°)；CE角由手术前的-10～10°(平均-02°)增加到手术后的37～49°(平均412°)，对照健侧髋关节，髋臼覆盖股骨头的百分比由手术前的0%(平均0%)增加到手术后的862%～1351%。[结论]单一的手术方式是不能治疗大年龄儿童髋关节脱位手术后再脱位，联合手术是一种积极有效的治疗方法，但是，手术前明确脱位后的关节状态以及手术中的仔细操作也非常重要。

    关键词：髋脱位；再脱位；联合截骨；大年龄儿童

    Combined osteotomy in the treatment of redislocation of developmental dislocation of hip in older children

    LV Honghai,WANG Peng,ZHANG Min,et al

    Department of Peadiatric Orthopaedics,Rich Chilren Hospital,Nantong,Jiangsu 226010

    Abstract：[Objective]To discuss the meanings and methods in the treatment of redislocation of developmental dislocation of hip(DDH)in older children[Method]From 1992 to 2003,9 children with 9 hips(aged from 8 to 14),who suffered from redislocation of DDH,were operated with the technique of combined osteotomy,which was composed of Pembertons acetabuloplasty,improved Zachradniceks and thighbone osteotomyThe reasons and preventive measures of the redislocation were studied[Result]According to the followedup ranged from 1 to 9 years,5 hips were found being excellent with the rate of 556%,3 hips were good with the rate of 333%,1 hip joint had restriction in abduction and flection,with the rate of 111%The postoperative acetabular angle decreased from preoperative 31~43(averaged,325 )to 5 ~19(averaged,112);center edge angle increased from10~10(averaged,02)to 37~49(averaged,412),the head of thighbones overlay were up from 0% to 862%~1351%[Conclusion]Instead of other simple methods,the combined technique has proved to be a positive and effective treatmentHowever,its important to confirm the dislocation state of the hip before surgery and to operate carefully ......

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