关节镜辅助治疗幼儿发育性髋关节脱位长期随访报告

发布时间：2018-02-28 00:44

  本文关键词： 髋关节镜 发育性髋关节脱位 髋臼截骨术　出处：《中国微创外科杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的探讨髋关节镜辅助治疗小儿发育性髋关节脱位(developmental dislocation of the hips,DDH)的临床效果。方法 2005年1月~2010年12月采用髋前侧及大粗隆前上入路髋关节镜技术完成16例(17髋)关节镜下增生滑膜刮除,股骨头圆韧带切除,髋臼底脂肪组织清理,髋臼横韧带松解,盂唇成形术,术毕髋屈曲外展位管型石膏外固定。术后3、6、9、12个月进行随访,随访12个月时,如果髋臼角25°二期行髋臼囊外截骨成形、股骨旋转(内翻、短缩)截骨等治疗。随访1年后每6个月随访1次,测量患儿骨盆髋臼角并进行Mckay和Severin评分。结果平均手术时间30.2 min(22~36 min),术中出血平均13.8 ml(10~25 ml),平均住院4.2 d(3~5 d)。16例(17髋)随访60~132个月(中位数91个月),按Mckay标准,优16髋,良1髋,优良率100%,按Severin标准,Ⅰ级13髋,Ⅱ级2髋,优良率88.2%(15/17)。结论髋关节镜技术可以使髋关节有效复位、刺激髋臼软骨发育,必要时配合行二期髋臼囊外截骨成形、股骨截骨(旋转、内翻、短缩)是治疗年龄18个月DDH的有效方法。盂唇外2/3切开的手术方式,保留内缘完整,能有效防止术后再脱位。
[Abstract]:Objective to investigate the clinical effect of arthroscopic assisted treatment of developmental dislocation of the dislocation in children. Methods from January 2005 to December 2010, 16 patients (17 hips) were treated with anterior hip arthroscopy and anterior superior hip trochanteric approach. Arthroscopic synovial accretion, Round ligament of femoral head was excised, adipose tissue of acetabular floor was cleaned up, acetabular transverse ligament was loosened, pyeloplasty, external fixation of external plaster of hip flexion was completed. If the acetabular angle is 25 掳secondary, the external acetabular osteotomy, the rotation osteotomy of the femur (varus, short contraction), and so on. Results the average operation time was 30.2 min(22~36 / min, the average intraoperative bleeding was 13.8 ml(10~25 / ml, and the average hospital stay was 4.2 days, 3 / 5 days / 5 days. 17 hips were followed up for 60 ~ 132 months (median 91 months). According to Mckay criteria, 16 hips were excellent and 1 was good. According to Severin standard, 13 hips of grade 鈪，

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