| 赵云龙 陈烁 周利武 郭亭 包倪荣 赵建宁.股骨短缩截骨全髋置换术治疗青年Crowe IV 型髋关节发育不良[J].,2016,16(9):1671-1675 |
| 股骨短缩截骨全髋置换术治疗青年Crowe IV 型髋关节发育不良 |
| Short-termOutcome of Total Hip Arthroplasty with Femoral ShorteningOsteotomy in Treatment of Adolescent Crowe Type IV DevelopmentalDysplasia of the Hip* |
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| DOI： |
| 中文关键词: 发育性髋关节发育不良 全髋关节置换术 股骨短缩截骨 软组织松解 |
| 英文关键词: Developmental dysplasia of the hip Total hip arthroplasty Femoral shortening osteotomy Soft tissue release |
| 基金项目:江苏省临床医学科技专项资助（BL2012002） |
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| 中文摘要: |
| 目的：总结股骨短缩截骨结合全髋关节置换术治疗青年Crowe IV 型髋关节发育不良（DDH）的近期疗效。方法：2009 年1 月
至2015 年1 月期间我院收治的22 例（24 髋）青年Crowe IV 型髋关节发育不良患者，其中男4 例（5 髋），女18 例（19 髋），年龄
17~27 岁，平均22 岁。记录患者术前、术后髋关节功能Harris评分、髋关节疼痛VAS评分和下肢长度差异。收集患者临床及影像
学资料。结果：22 例患者均获随访，随访时间6～72 个月，平均38 个月。截骨端均骨性愈合，愈合时间3～ 6 个月，平均3.2 个月。
Harris 评分由术前（43.2 ± 2.7）分改善至（95.3 ± 2.8）分，效果显著（P＜0.01），髋关节疼痛VAS评分由术前(6. 0 ± 1. 0)分改善至
(1.0 ± 0.5) 分，疼痛明显缓解（P＜0.05），下肢长度差异由术前（55.5± 15.5）mm减少至（16.5± 5.5）mm，显著改善（P＜0.01）。术后2
例合并坐骨神经麻痹，但6 个月内症状完全缓解，6 例遗留轻度跛行。随访期间均无假体翻修，未发现材料与宿主的生物相容性反
应。结论：股骨短缩截骨全髋置换术治疗青年Crowe IV 型髋关节发育不良的近期疗效满意，术中综合考虑软组织松解程度与短缩
截骨方式及长度可有效的解决患者肢体短缩、避免神经血管损伤及改善患者术后髋关节功能。 |
| 英文摘要: |
| Objective:To analyze and summarize the short-term efficacy of total hip arthroplasty with femoral shortening in treatment
of youth Crowe type IV developmental hip dysplasia（DDH).Methods:From January 2009 to January 2015,22 young patients（24
hips）with Crowe type IV DDH were treated by total hip arthroplasty with femoral shortening. There were 4 males (5 hips) and 18 females
(19 hips), with an average age of 22 years (range, 17 to 27 years).A visual analog scale (VAS) evaluated the hip pain, Harris hip
score evaluated the hip joint function and the leg discrepancy were recorded before and after the operation. The clinical and radiological
results of these patients were collected.Results:Patients were followed up for an average of 38 months (range 6 to 72 months). The healing
time of fracture was an average of 3.2 months ( range 3 to 6 months). The Harris score was improved from（43.2± 2.7）preoperatively
to（95.3± 2.8）postoperatively, showing significant difference (P＜0.01). The VAS score was improved significantly after the operation
(P＜0.05) from(6. 0± 1. 0) to (1. 0 ± 0.5). The leg discrepancy was（16.5± 5.5）mm after operation, showing significant difference when
compared with the one（55.5± 15.5）mmbefore the operation（P＜0.01）. After surgery, 6 cases had mild claudication.Besides,2 cases had
sciatic nerve palsy but which resolved completely in 6 months. There was no biocompatibility between the materials and the hosts, and no
revision of acetabular and femoral prostheses was performed during follow-up.Conclusion:The total hip arthroplasty with femoral
shortening osteotomy can receive satisfied short-term effect in treatment of adolescent Crowe type IV developmental dysplasia of the hip.
Taking into consideration various factors, including the degree of release of the soft tissue and the way and length of femoral shortening
osteotomy, can reduce the leg discrepancy effectively, avoid damaging the vessels and nerves and improve the function of hip-joint. |
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