摘要
目的:探讨人工全髋关节置换术治疗Crowe Ⅳ型成人髋关节发育不良的疗效及围手术期并发症。方法:2000年3月至2010年3月,对19例(23髋)Crowe Ⅳ型成人髋关节发育不良患者进行人工全髋关节置换术,其中男5例,女14例;年龄41～72岁,平均61.3岁。髋臼侧采用小臼杯结合髋臼内陷技术安置臼杯假体,股骨侧采用粗隆下短缩截骨放置股骨假体。采用Harris评分评价术后髋关节功能。结果:所有患者获随访,时间1～8年,平均4.2年,术后X线片显示髋臼假体均位于真臼内,无髋臼假体松动。股骨侧截骨处均骨性愈合。Harris评分由术前平均(34.0±6.9)分提高至末次随访的(85.0±7.5)分。发生围手术期并发症11例,包括股骨劈裂骨折3例,神经并发症3例,截骨延迟愈合2例,术后脱位3例。结论:采用小臼杯、假体内陷技术、股骨短缩截骨对Crowe Ⅳ型DDH患者行全髋关节置换可以重建关节功能,恢复下肢长度,早期疗效满意,但并发症发生率高。后期疗效有待进一步观察。
Objective：To evaluate the clinical effects of total hip arthroplasty（THA） for Crowe type Ⅳ developmental dysplasia of the hip（DDH） and analyze perioperative complications. Methods：From March 2000 to March 2010,19 patients （23 hips,of them,4 patients with bilateral hips） with Crowe type Ⅳ DDH underwent THA. There were 5 males and 14 females,with average age of 61.3 years（ranged,41 to 72 years）. All hips were treated with small acetabular components combined with medial protrusion technique in acetabular reconstruction,as well as subtrochanteric shortening osteotomy in femur. Joint function of hips were evaluated according to Harris scoring. Results：All patients were followed up with an average of 4.2 years （ranged,1 to 8 years）. Postoperative X-ray films showed all acetabular prosthesis were in true acetabulum. No loosening and nonunion were found in all patients. Harris scoring improved from preoperative 34.0±6.9 to postoperative 85.0±7.5. Complications occurred in 11 cases in the patients,including femoral split fracture in 3 cases,nerve injury in 3 cases,delayed union in 2 cases,dislocation in 3 cases. Conclusion：Total hip arthroplasty using small acetabular component,medial protrusion,femoral subtrochanteric shortening osteotomy technique for the Crowe type Ⅳ DDH can effectively restore hip function and leg length. But incidence of complications is high. The long-term follow-up is necessary for further study.
出处
《中国骨伤》
CAS
2012年第1期74-77,共4页
China Journal of Orthopaedics and Traumatology
关键词
关节成形术
置换
髋
截骨术
围手术期并发症
Arthroplasty
replacement
hip
Osteotomy
Peroperative complications
