CroweⅣ型髋关节发育不良的全髋关节置换术

被引：16

作者：

吴岳嵩

汪滋民

王志伟

年申生

康一凡

徐卫东

机构：

[1] 上海长海医院骨科

来源：

中华骨科杂志 | 2010年 / 02期

关键词：

关节成形术,置换,髋; 髋脱位,先天性; 骨关节炎,髋; 截骨术;

D O I：

暂无

中图分类号：

R687.4 [关节手术];

学科分类号：

100220 [骨科学];

摘要：

目的探讨全髋关节置换术治疗成人CroweⅣ型髋关节发育不良(developmental dysplasiaof thehip,DDH)的方法并评价其疗效。方法 1997年10月至2009年1月,应用全髋关节置换术治疗CroweⅣ型DDH患者15例20髋,其中5例双侧、10例单侧。18髋采用Secur-Fit股骨假体,2髋采用Corail股骨假体。转子下斜行截骨6髋,髋臼底磨穿5髋,均行股骨头植骨。结果 15例中早期死亡1例(双髋),失访2例(2髋),余12例16髋获得平均44.2个月(5～92个月)随访。术后发生出血性休克1例,脂肪栓塞1例,术后脱位2例,股骨上端骨裂2例。转子下斜行截骨6髋中,1髋失随访,2髋分别于术后18和23个月随访时仍可见骨折线,下肢行走无异常,其余3髋骨愈合。髋臼底植骨5髋,除1髋失访外,其余均获得愈合。术后X线片显示髋臼假体均位于真臼内,完全骨性覆盖,无髋臼假体松动。术后双下肢长度差平均1.1 cm(0～2.2 cm)。末次随访Harris评分由术前平均(24.7±5.7)分(15～32分)提高至末次随访(85.6±5.6)分(80～94分),差异有统计学意义。结论对CroweⅣ型DDH患者行全髋关节置换术时,良好的真臼暴露、加深髋臼、股骨短缩、斜行截骨及使用Secur-Fit假体能提高全髋关节置换术的治疗效果。

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