DDH股骨近端截骨儿童髋部锁定板与普通锁定板固定的比较

发布时间：2018-04-22 10:12

本文选题：儿童髋部锁定加压接骨板 + 普通锁定加压钢板　；参考：《中国矫形外科杂志》2017年23期

【摘要】：[目的]对比分析儿童髋部锁定加压接骨板(locking compression pediatric hip plate,LCP-PHP)与普通锁定加压钢板(locking compression plate,LCP)联合Salter截骨术治疗儿童发育性髋关节脱位(developmental dysplasia of the hip,DDH)的临床疗效。[方法]回顾性分析本院2013年12月~2015年12月收治的46例60髋DDH患儿。所有患者均按照Salter截骨术联合股骨近端截骨术治疗,根据股骨截骨内置物的不同,22例29髋使用LCP-PHP钢板固定(儿童板组),24例31髋使用普通LCP钢板固定(普通板组)。临床随访采用Mckay标准对髋关节功能评分,X线随访采用Severin标准。[结果]患者均顺利完成手术,术后随访12~36个月,平均(19.0±7.2)个月。两组术前股骨颈干角、前倾角、髋臼指数、中心边缘角差异无统计学意义(P0.05),两组术后及末次随访时股骨颈干角、前倾角、髋臼指数、中心边缘角均较术前有明显改善,差异有统计学意义(P0.01)。两组间比较儿童板组术后及末次随访时股骨颈干角、前倾角改善更明显,与普通板组间差异有统计学意义(P0.01)。根据Severin标准:儿童板组优良率(96.56%),普通板组优良率(93.55%),两组优良率比较差异无统计学意义(x2=0.000,P=1.000);根据Mckay标准:儿童板组优良率(96.56%),普通板组优良率(74.19%),两组优良率比较差异有统计学意义(x2=4.252,P=0.039)。[结论]LCP-PHP钢板治疗儿童DDH比普通LCP钢板矫形效果好,具有符合解剖及生物力学特点、角度稳定性强、对骨膜及血供损伤小、并发症少、截骨愈合快可早期功能锻炼的优点。
[Abstract]:[objective] to compare and analyze the clinical effects of locking compression pediatric hip plate LCP-PHP and locking compression plate LCPC combined with Salter osteotomy in the treatment of developmental dysplasia of the hip dislocation in children. [methods] 46 cases (60 hips) with DDH from December 2013 to December 2015 were retrospectively analyzed. All the patients were treated by Salter osteotomy combined with proximal femur osteotomy. According to the different femoral osteotomy, 29 hips of 22 cases were fixed with LCP-PHP plate. Mckay standard was used to evaluate hip function and Severin standard was used in X-ray follow-up. [results] all the patients completed the operation successfully and followed up for 12 ~ 36 months, with an average of 19.0 卤7.2 months. There was no significant difference in femoral neck trunk angle, anteversion angle, acetabular index and central margin angle between the two groups before operation (P 0.05). The angle of femoral neck trunk, anteversion angle, acetabular index and central margin angle were significantly improved after operation and at the last follow-up in both groups. The difference was statistically significant (P 0.01). The angle of femoral neck trunk was significantly improved in the children's plate group after operation and at the last follow-up, and the difference between the two groups was statistically significant (P 0.01). According to the Severin standard, the excellent and good rate of the children's plate group was 96.560.The excellent and good rate of the common board group was 93.55. There was no significant difference in the excellent and good rate between the two groups. According to the Mckay standard, the excellent and good rate of the children's board group was 96.566.The excellent and good rate of the common board group was 74.19B. the difference between the two groups was statistically significant. [conclusion] LCP-PHP plate is more effective than common LCP plate in the treatment of pediatric DDH. It has the advantages of anatomical and biomechanical characteristics, strong angle stability, less injury to periosteum and blood supply, less complications, quick osteotomy and early functional exercise.
【作者单位】：成都体育学院;四川省骨科医院;
【基金】：国家自然科学基金项目(编号:51273028)
【分类号】：R726.8

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