關(guān)節(jié)鏡輔助治療幼兒發(fā)育性髖關(guān)節(jié)脫位長(zhǎng)期隨訪報(bào)告
發(fā)布時(shí)間:2018-02-28 00:44
本文關(guān)鍵詞: 髖關(guān)節(jié)鏡 發(fā)育性髖關(guān)節(jié)脫位 髖臼截骨術(shù) 出處:《中國(guó)微創(chuàng)外科雜志》2017年11期 論文類型:期刊論文
【摘要】:目的探討髖關(guān)節(jié)鏡輔助治療小兒發(fā)育性髖關(guān)節(jié)脫位(developmental dislocation of the hips,DDH)的臨床效果。方法 2005年1月~2010年12月采用髖前側(cè)及大粗隆前上入路髖關(guān)節(jié)鏡技術(shù)完成16例(17髖)關(guān)節(jié)鏡下增生滑膜刮除,股骨頭圓韌帶切除,髖臼底脂肪組織清理,髖臼橫韌帶松解,盂唇成形術(shù),術(shù)畢髖屈曲外展位管型石膏外固定。術(shù)后3、6、9、12個(gè)月進(jìn)行隨訪,隨訪12個(gè)月時(shí),如果髖臼角25°二期行髖臼囊外截骨成形、股骨旋轉(zhuǎn)(內(nèi)翻、短縮)截骨等治療。隨訪1年后每6個(gè)月隨訪1次,測(cè)量患兒骨盆髖臼角并進(jìn)行Mckay和Severin評(píng)分。結(jié)果平均手術(shù)時(shí)間30.2 min(22~36 min),術(shù)中出血平均13.8 ml(10~25 ml),平均住院4.2 d(3~5 d)。16例(17髖)隨訪60~132個(gè)月(中位數(shù)91個(gè)月),按Mckay標(biāo)準(zhǔn),優(yōu)16髖,良1髖,優(yōu)良率100%,按Severin標(biāo)準(zhǔn),Ⅰ級(jí)13髖,Ⅱ級(jí)2髖,優(yōu)良率88.2%(15/17)。結(jié)論髖關(guān)節(jié)鏡技術(shù)可以使髖關(guān)節(jié)有效復(fù)位、刺激髖臼軟骨發(fā)育,必要時(shí)配合行二期髖臼囊外截骨成形、股骨截骨(旋轉(zhuǎn)、內(nèi)翻、短縮)是治療年齡18個(gè)月DDH的有效方法。盂唇外2/3切開的手術(shù)方式,保留內(nèi)緣完整,能有效防止術(shù)后再脫位。
[Abstract]:Objective to investigate the clinical effect of arthroscopic assisted treatment of developmental dislocation of the dislocation in children. Methods from January 2005 to December 2010, 16 patients (17 hips) were treated with anterior hip arthroscopy and anterior superior hip trochanteric approach. Arthroscopic synovial accretion, Round ligament of femoral head was excised, adipose tissue of acetabular floor was cleaned up, acetabular transverse ligament was loosened, pyeloplasty, external fixation of external plaster of hip flexion was completed. If the acetabular angle is 25 擄secondary, the external acetabular osteotomy, the rotation osteotomy of the femur (varus, short contraction), and so on. Results the average operation time was 30.2 min(22~36 / min, the average intraoperative bleeding was 13.8 ml(10~25 / ml, and the average hospital stay was 4.2 days, 3 / 5 days / 5 days. 17 hips were followed up for 60 ~ 132 months (median 91 months). According to Mckay criteria, 16 hips were excellent and 1 was good. According to Severin standard, 13 hips of grade 鈪,
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