摘要
目的介绍经髂腹股沟入路在骨盆内壁行伯尔尼髋臼周围截骨术治疗成人髋臼发育不良。方法1997年10月～2001年4月,共有51例患者(53髋)因髋臼发育不良造成髋关节疼痛而接受经髂腹股沟入路髋臼周围截骨术(Berneseperiacetabularosteotomy)。患者平均年龄30.6岁(13～48岁,其中1例13岁患者的髋臼骨骺已完全闭合),男∶女=1∶10。术前患者平均疼痛3.4年(3个月～15年);髋关节活动度正常或基本正常(235°～360°,平均300°)。术前X线片显示CE角?15°～15°,平均1.1°;臼顶倾斜角为15°～55°,平均28°;髋关节间隙正常或轻度狭窄。53%的髋关节伴有不同程度的半脱位(Shenton线不连续)。结果24例(24髋)有12～38个月(平均26个月)的随访结果。24髋术后疼痛明显减轻,髋关节活动度保持正常。Harris评分从术前平均79.8分(64～83分)提高到术后平均93.8分(75～100分)。术后CE角平均为40°(20°～60°),臼顶倾斜角平均为9°(0°～20°),Shenton线不连续率降为33%。术中及术后并发症包括股神经损伤1例,膀胱功能障碍1例,切口疝2例。结论骨盆内髋臼周围截骨术治疗成人髋臼发育不良可以获得良好疗效。该术式的特点为:在保持骨盆环和髋外展肌完整的基础上,可以最大限度地改善髋关节畸形,恢复髋关节的解剖关系。
Objective To introduce the Bernese periacetabular osteotomy through ilioinguinal approach for the treatment of adult acetabular dysplasia. Methods From October 1997 to April 2001, 51 patients(53 hips) with acetabular dysplasia were operated upon with Bernese periacetabular osteotomies through ilioinguinal approach. The mean age of the patients at the time of surgery was 30.6 years(range, 13-48 years). Male∶female= 1∶10. Preoperatively, the average duration of the symptoms was 3.4 years(3 months to 15 years), the range of motion(ROM) of the hip was normal in most patients. Average CE angle was 1.1°(?15°-15°); the Tonnis osteoarthritis grade was Ⅰto Ⅱ. Fifty three percent of the hips had Shentons line broken. Results Twenty four hips had 12 to 38 months followed up. Most patients were pain free; the hip ROM remained normal. Harris hip score increased from 79.8(64-83) pre operatively to 93.8(75-100) post operatively. CE angle increased to 40°(20°to 60°). Shentons line broken rate decreased to 33%. The complications include: 1 femoral nerve damage, 1 bladder malfunction and 2 skin incision hernia. Conclusion The Bernese periacetabular osteotomy through ilioinguinal approach is a safe and efficient procedure for the treatment of adult acetabular dysplasia. The deformities could be easily corrected, the anatomic relations could be restored nicely, the pelvic ring and the abductor muscles are reserved. The post operative recovery is fast, and it is efficient to prevent the development of osteoarthritis of the hip joint.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2001年第11期658-661,共4页
Chinese Journal of Orthopaedics
