髋臼结构植骨在Crowe Ⅲ或Ⅳ型髋关节发育不良关节置换术中的应用

被引：6

作者：

朱俊峰

陈晓东

沈超

崔一民

蔡贵泉

机构：

[1] 上海交通大学医学院附属新华医院骨科

来源：

中华解剖与临床杂志 | 2014年 / 19卷 / 01期

关键词：

髋关节发育不良; 全髋关节置换; 结构植骨; 截骨;

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：

目的探讨髋臼结构植骨在Crowe Ⅲ、Ⅳ型髋关节发育不良(DDH)人工全髋关节置换术(THR)中应用的短期效果。方法对2008年7月—2011年6月, 全髋关节置换术(THR)中采用结构性植骨结合非骨水泥臼杯进行髋臼侧重建治疗的38例43髋Crowe Ⅲ型或Ⅳ型DDH患者的短期疗效进行回顾性分析。男5例(5髋), 女33例(38髋), 平均年龄41岁。术前Harris评分平均51分, 19髋术中联合行转子下横行短缩截骨, 平均1.6 cm。结果术后平均随访39个月。末次随访Harris评分平均92分。肢体长度差异由术前的平均4.4 cm减少至术后0.7 cm。术后髋关节旋转中心平均下移3.2 cm, 内移2.8 cm。所有髋臼假体无松动或感染, 髋臼结构植骨块均愈合。术后异位骨化1髋, 关节脱位1髋, 闭合复位成功。结论自体结构性植骨结合非骨水泥臼杯重建Crowe Ⅲ、Ⅳ型髋关节发育不良的旋转中心, 短期效果令人满意, 无植骨不愈合、骨块吸收或松动等并发症。

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