縫匠肌骨瓣修補(bǔ)大齡兒童發(fā)育性髖關(guān)節(jié)脫位髖臼缺損的療效分析
本文選題:髖脫位 切入點(diǎn):先天性 出處:《重慶醫(yī)學(xué)》2017年23期 論文類型:期刊論文
【摘要】:目的評(píng)價(jià)縫匠肌骨瓣修補(bǔ)髖臼缺損在治療大齡兒童發(fā)育性髖關(guān)節(jié)脫位(DDH)的早期手術(shù)療效。方法回顧性分析該院2014-2016年縫匠肌骨瓣修補(bǔ)髖臼缺損治療17例DDH伴髖臼缺損大齡患兒(6歲)的臨床資料,評(píng)價(jià)早期手術(shù)療效。在全身麻醉下行髖關(guān)節(jié)切開復(fù)位;股骨轉(zhuǎn)子下三維截骨糾正前傾角及頸干角,根據(jù)股骨頭脫位高度行股骨短縮,鋼板固定后重建關(guān)節(jié)囊。取髂骨縫匠肌骨瓣翻轉(zhuǎn)至髖臼上緣修補(bǔ)髖臼缺損。手術(shù)后雙下肢貝氏石膏固定6~8周。逐漸行髖關(guān)節(jié)功能訓(xùn)練,髖關(guān)節(jié)功能參照Mckay′s標(biāo)準(zhǔn)進(jìn)行評(píng)估,髖關(guān)節(jié)形態(tài)評(píng)估參照Severin′s X射線標(biāo)準(zhǔn)進(jìn)行。結(jié)果 17例患兒均獲得隨訪,隨訪時(shí)間6~29個(gè)月。術(shù)后股骨頭復(fù)位良好,頭臼包容滿意;未出現(xiàn)傷口感染及股骨頭壞死。術(shù)后隨訪結(jié)果,Mckay′s標(biāo)準(zhǔn):優(yōu)2例(2髖),良13例(15髖),可2例(2髖),優(yōu)良率為88.2%,Severin′s標(biāo)準(zhǔn):優(yōu)11例,良49例。結(jié)論大齡兒童(6歲)DDH采用髂骨縫匠肌骨瓣修補(bǔ)髖臼缺損,術(shù)后骨性愈合好,能有效改善髖關(guān)節(jié)的髖臼對(duì)股骨頭的包容,術(shù)后關(guān)節(jié)功能良好。
[Abstract]:Objective to evaluate the early operative effect of repairing acetabular defect with sartorius muscle bone flap in elderly children with developmental dislocation of hip. Methods 17 cases of DDH with acetabular defect were retrospectively analyzed. The clinical data of the older children (6 years old), To evaluate the effect of early operation. Open reduction of hip joint under general anesthesia, correction of anteversion angle and neck shaft angle by subtrochanteric osteotomy, short contraction of femur according to the height of dislocation of femoral head. The bone flap of iliac sartorius muscle was reversed to the upper edge of acetabular to repair the acetabular defect. After the operation, the lower extremities were fixed with Bayesian plaster for 6 to 8 weeks. The function of hip joint was gradually trained, and the function of hip joint was evaluated according to Mckay's standard. Results all the 17 cases were followed up for 6 ~ 29 months. The femoral head was restored well and the head and acetabulum was well contained after operation. There was no wound infection or femoral head necrosis. The results of follow up were as follows: excellent 2 cases, good 13 cases 15 hips, fair 2 cases, and excellent and good rate 88. 2% Severinus standard: 11 cases were excellent. Conclusion the bone flap of iliac sartorius muscle was used to repair the acetabular defect in the older children aged 6 years, and the bone healed well after operation, which can effectively improve the acetabular inclusion of the femoral head and the function of the joint after operation.
【作者單位】: 重慶醫(yī)科大學(xué)附屬兒童醫(yī)院骨科中心;
【基金】:國(guó)家臨床重點(diǎn)專科建設(shè)項(xiàng)目資助(國(guó)衛(wèi)辦醫(yī)函【2013】544)
【分類號(hào)】:R726.8
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