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目的 :回顾性分析从 1 985年 1月～ 1 995年 1月采用综合术式治疗先天性髋脱位 88例 (96髋 )的临床效果及影响因素。方法 :按患儿年龄分 3组 ,结合其病理选择手术方法 ,包括切开复位、骨盆截骨、粗隆下旋转截骨或同时股骨短缩。平均纠正前倾角 45°,切除股骨 1 .5cm。 2 .5～ 3 .5岁行Salter术 2 2髋、Salter+股骨截骨 7髋 ;3 .5～ 5岁行Salter+股骨截骨 1 9髋、Chiari+股骨截骨 1 6髋、髋臼造盖 +股骨截骨 9髋 ;5岁以上行髋臼造盖 +Chiari+股骨截骨 2 3髋。结果 :获随访 65例 70髋 ,平均随访 6 .5年 (4～ 1 4年 )。按Mckay临床评定标准 ,优良者 61髋占 87% ;可 3髋占 4 .3 % ;差 6髋占 8.6 %。差中有 3髋因半脱位再手术。 3髋有头坏死占 4 .3 %。结论 :根据患儿及其病理选择综合术式纠正头臼异常改变 ,恢复髋关节功能 ,减少复发 ,为一项实用方法。
Objective: To retrospectively analyze the clinical effects and influencing factors of 88 cases (96 hips) treated by integrative surgery from January 1985 to January 1995. Methods: The patients were divided into 3 groups according to the age of their children, combined with the pathological selection of surgical methods, including open reduction, pelvic osteotomy, subtrochanteric osteotomy or simultaneous femoral shortening. The average anteversion angle 45 °, resection femur 1.5cm. 2.5 to 3.5 years of Salter surgery 2 2 hips, Salter + femoral osteotomy 7 hips; 3.5 to 5 years old line Salter + femoral osteotomy 19 hips, Chiari + femoral osteotomy 16 hips, acetabular cap + Femoral osteotomy 9 hips; 5 years old acetabular cap + Chiari + femoral osteotomy 2 3 hips. Results: Sixty-five patients (70 hips) were followed up for an average of 6.5 years (range 4-14 years). According to Mckay’s clinical evaluation criteria, 61 hip patients accounted for 87% of the best, 3 hip patients accounted for 4.3%, and 6 poor women accounted for 8.6% of the patients. 3 hips due to subluxation and then surgery. 3 hip necrosis accounted for 4.3%. Conclusion: It is a practical method to correct the abnormality of acetabulum according to children and their pathological selection, to restore the function of hip joint and reduce the recurrence.