摘要
目的:比较骨盆三联截骨+股骨近端旋转截骨(A)、单纯骨盆三联截骨(B)及Salter骨盆截骨+股骨近端旋转截骨(C)3种手术方式治疗6岁以上发育性髋关节脱位的疗效。方法:回顾性分析2018年1月至2023年6月在郑州大学第一附属医院接受手术治疗的发育性髋关节脱位患儿44例(44髋),年龄6~14岁。以手术方式的不同分为A、B、C 3组。术前及术后采用X射线片测量髋臼指数(AI)、中心边缘角(CE角),根据Mckay髋关节功能评价标准和Severin髋关节影像学评级对比不同手术方式的疗效。结果:术后2 a, 3组Mckay功能优良率和Severin影像学优良率比较,差异均无统计学意义(P>0.05)。术后3个月、1 a、2 a A、B组AI小于C组,CE角大于C组;3组术后各时间点AI均较术前减小,CE角均较术前增大(P<0.05)。结论:3种术式术后髋关节功能(Mckay评分)和影像学优良率(Severin分级)无差异,但骨盆三联截骨联合/单纯术式在髋臼形态矫正(AI、CE角)方面更具优势。
Aim:To compare the effects of three surgical methods,namely,triple pelvic osteotomy combined with proximal femoral and rotational osteotomy(A),triple pelvic osteotomy alone(B),and Salter pelvic osteotomy combined with proximal femoral and rotational osteotomy(C),in the treatment of developmental dislocation of the hip in children over 6 years old.Methods:A retrospective analysis was conducted on 44 pediatric patients(44 hips)with developmental dislocation of the hip who underwent surgical treatment in the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2023.The patients were aged 6 to 14 years.Based on the surgical approach,they were divided into groups A,B,and C.Preoperative and postoperative X-rays were used to measure the acetabular index(AI) and center-edge angle(CE angle).The efficacy of different surgical approaches was compared using Mckay hip function evaluation criteria and Severin radiological hip grading system.Results :At 2 years postoperatively,there were no significant differences in the excellent/good rates of Severin hip radiographic rating and Mckay hip function evaluation among the 3 groups( P >0.05).However,at all postoperative follow-up time points(3 months,1 year,2 years),the AI in groups A and B was significantly smaller than that in group C,while the CE angles in groups A and B were significantly larger than that in group C( P <0.05).In all 3 groups,both AI and CE angles showed significant improvements after operation( P <0.05).Conclusion :There is no significant difference in hip joint function(Mckay score) or excellent/good rates of radiographic evaluation(Severin classification) among the 3 surgical methods after operation.However,the triple pelvic osteotomy combined with or alone has more advantages in correcting the acetabular morphology(AI,CE angle).
作者
李潮
张杰
史龙彦
张辉
宋东建
苏萌
汪奇
赵昀政
尹梦雯
邹鑫磊
梁鹏伟
高晓斌
刘秋亮
LI Chao;ZHANG Jie;SHI Longyan;ZHANG Hui;SONG Dongjian;SU Meng;WANG Qi;ZHAO Yunzheng;YIN Mengwen;ZHOU Xinlei;LIANG Pengwei;GAO Xiaobin;LIU Qiuliang(Department of Pediatric Surgery,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Hongshankou Outpatient Department,Beijing North Medical District,PLA General Hospital,Beijing 100091)
出处
《郑州大学学报(医学版)》
北大核心
2025年第3期309-313,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
河南省医学科技攻关计划省部共建项目(SB201901019)
河南省科技厅高端外国专家引进计划项目(HNGD2021032)
河南省教育厅高等学校重点科研项目计划(23A320054)
河南省中青年卫生健康科技创新领军人才培养项目(YXKC2022013)。
关键词
发育性髋关节脱位
大龄儿童
骨盆三联截骨
SALTER骨盆截骨
疗效
developmental dislocation of the hip
older children
triple pelvic osteotomy
Salter pelvic osteotomy
therapeutic effect
