Pemberton截骨术联合软组织松解及股骨上段截骨治疗发育性髋关节.docVIP

Pemberton截骨术联合软组织松解及股骨上段截骨治疗发育性髋关节 　 作者：王旭，董平，韵向东，汪静，夏亚一，王栓科 【摘要】 [目的]总结Pemberton截骨术治疗发育性髋关节脱位的临床经验，强调联合化及个体化原则。[方法]选择1996年2月～2007年4月期间3～10岁CDH患儿26例，计28髋，均行Pemberton截骨术辅以广泛软组织松解、股骨上段矫形截骨等联合手术治疗，测定并对比其术前、术后AI角、CE角、髋臼的深度等指标，并以Severin影像学及Mckay临床疗效评价标准加以评价。[结果]本组26例均得到随访，平均43个月。 根据Severin影像学评价标准，优64.3%，良28.6%，可7.1%，而根据McKay临床疗效评价标准，优50.0%，良35.8%，可7.1%，差7.1%。总体上影像学评价优于临床疗效。[结论]Pemberton截骨手术治疗发育性髋关节脱位是安全、有效的，联合化是提高成功率、减少并发症的必要条件，同时也必须强调治疗的个体化原则。 【关键词】 Pemberton截骨术; 发育性髋关节脱位; 手术冶疗 Application of Pembertons osteotomy in the treatment of congenital hip dislocation of chidren∥WANG Xu, DONG Ping,YUN Xiang-dong,et al.Department of Pediatrics, Second Hospital, Lanzhou University, Lanzhou 730030, China 　　Abstract: [Objective]To summarize clinical experience of Pemberton’s ilium osteotomy in developing hip dislocation and emphasize the combined and individual principles in the clinical practice. [Methods]From February 1996 to April 2007, 26 patients(aged 3 to 10 years) with 28 hips were operated on together with soft tissue solution, a pericapsular osteotomy of the ilium (Pemberton) and an optional femoral rotational，shortening or varus osteotomy of the proximal femur. Pre- and post-operative indexes including those of AI angle, CE angle and deep of acetabulum were compared. According to Severin’s classification and McKay clinical curative effect evaluation critera, these indexes were evaluated.[Results]According to the Severin’s classification,the results were rated as 64.3% excellent, 28.6% good and 7.1% fair.On the McKay’s critera ,the functional results were graded as 50.0% excellent, 35.8% good, 7.1% fair and 7.1% poor. On the whole, the radiographic evaluation was superior to that of the functional results.[Conclusion]The Pemberton?s osteotomy is safe and effective.The combined surgical treatment can improve the success rate and decrease complications. 　　Key words：Pembertons ilium osteotomy; developmental dysplasia of the hip; operative therapy 　　发育性髋关节脱位(developmental dysp