单纯Pemberton髋臼成形术与联合股骨粗隆下旋转缩短截骨术治疗发育性髋关节脱位

发布时间：2018-05-21 02:36

本文选题：髋脱位 + 先天性　；参考：《吉林大学》2012年硕士论文

【摘要】：目的:回顾性比较单纯Pemberton髋臼成形术与联合股骨粗隆下旋转缩短截骨手术治疗发育性髋关节脱位的临床疗效。资料与方法:2004年1月至2009年1月,对采用单纯Pemberton髋臼成形术或Pemberton髋臼成形术联合股骨粗隆下旋转缩短截骨手术治疗且获随访的141例发育性髋关节脱位患者的资料进行回顾性分析,其中57例采用单纯Pemberton髋臼成形术治疗(单纯髋臼成形手术组),男12例,女45例，年龄3~8岁；84例用Pemberton髋臼成形术联合股骨粗隆下旋转缩短截骨手术治疗(联合手术组)，男15例，女69例，年龄4~9岁。比较2组术后并发症及术后2年进行Severin放射学评价，并采用Mckay临床评定标准评价2组疗效。结果:单纯髋臼成形手术组患者随访30～52个月，平均38个月；联合手术组患者随访32～51个月，平均37个月。单纯髋臼成形手术组7例再脱位,4例股骨头坏死，5例关节僵硬；联合手术组无再脱位、股骨头坏死、患肢缩短，2例关节僵硬。术后２年McKay临床疗效评定结果：单纯髋臼成形手术组优27髋，良18髋，可12髋；联合手术组优52髋，良25髋，可7髋。联合手术组疗效优于单纯髋臼成形手术组。Severin X线评定标准结果：单纯髋臼成形手术组优27髋，良15髋，可15髋；联合手术组优53髋，良22髋，可9髋。联合手术组优于单纯髋臼成形手术组。结论:与单纯髋臼成形手术相比,联合手术治疗发育性髋关节脱位在术后减少严重并发症及功能恢复方面有明显优势。联合手术组患者对术后综合结果更为满意。
[Abstract]:Objective: to retrospectively compare the clinical effect of Pemberton acetabular arthroplasty combined with subtrochanteric rotation shortening osteotomy in the treatment of developmental dislocation of hip. Information and methods: January 2004 to January 2009, The data of 141 patients with developmental dislocation of hip treated by Pemberton acetabular plasty or Pemberton acetabular arthroplasty combined with subtrochanteric rotation shortening osteotomy were retrospectively analyzed. 57 cases were treated with simple Pemberton acetabular plasty (simple acetabular arthroplasty group, 12 males, 45 females, aged 3 or 8 years, 84 patients were treated with Pemberton acetabular arthroplasty combined with subtrochanteric rotation shortening osteotomy) (combined operation group, 15 cases, male, 15 cases). 69 females, aged 4 to 9 years. The postoperative complications and Severin radiologic evaluation were compared between the two groups, and the clinical evaluation criteria of Mckay were used to evaluate the efficacy of the two groups. Results: the patients in the simple acetabular arthroplasty group were followed up for 30 ~ 52 months (mean 38 months) and the combined operation group for 32 ~ 51 months (mean 37 months). In the simple acetabular arthroplasty group, there were 7 cases of redislocation and 4 cases of osteonecrosis of femoral head and 5 cases of joint stiffness, while in the combined operation group, there was no redislocation, necrosis of the femoral head, and joint stiffness in 2 cases. 2 years after operation, the clinical efficacy of McKay was evaluated as follows: 27 hips were excellent, 18 hips were good, 12 hips were fair in simple acetabular arthroplasty group, 52 hips were excellent, 25 hips were good and 7 hips were fair in combined operation group. The curative effect of combined operation group was better than that of simple acetabular arthroplasty group. Results: 27 hips were excellent, 15 hips were good, 15 hips were fair in simple acetabular arthroplasty group, 53 hips were excellent, 22 hips were good and 9 hips were fair in combined operation group. The combined operation group was superior to the simple acetabular plasty group. Conclusion: compared with simple acetabular arthroplasty, combined operation for developmental dislocation of hip has obvious advantages in reducing serious complications and functional recovery. The patients in the combined operation group were more satisfied with the comprehensive results.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.8

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