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目的：观察发育性髋脱位复位后粗大圆韧带所致股骨头坏死的临床特点，探讨其机理。方法：对发育性髋脱位手法复位后股骨头坏死，术中发现为粗大圆韧带所致者８例进行了回顾性观察，通过系列Ｘ线片，测定髋臼指数、臼头指数、髋臼形态及股骨头的发育情况，并对术中所见综合分析。结果：复位后股骨头、髋臼不发育或发育缓慢，股骨头变扁且以内下方明显，髋臼指数恢复缓慢，最终以股骨头坏死、半脱位、髋臼发育不良为特征。术中见有明显增宽、增厚的圆韧带嵌于头臼之间，股骨头中心及内下方变扁且有圆韧带压痕；术后受压的股骨头逐渐膨起。结论：巨大间置物——粗大圆韧带是发育性髋脱位手法复位后股骨头坏死的重要病理因素之一，应通过影像检查在复位前辨认，作为手法复位的禁忌证。
Objective: To observe the clinical characteristics of osteonecrosis of the femoral head caused by the development of the coarse round ligament after dislocation development and to explore its mechanism. Methods: Eight cases of osteonecrosis of the femoral head after dislocation of the developmental hip dislocation were resected. The results of the operation were retrospectively observed in 8 cases caused by the ligamentum. The series of X-ray films were used to determine the acetabular index, acetabular index, acetabular morphology And the development of the femoral head, and comprehensive analysis of intraoperative findings. Results: After resetting, the femoral head and acetabulum were not developed or developed slowly. The femoral head became flat and obvious in the inferior part. The acetabular index recovered slowly. Finally, the femoral head necrosis, subluxation and acetabular dysplasia were characterized. See the surgery was significantly wider, thickening of the round ligament embedded in the head between the mortar, the lower center of the femoral head and the lower flat and round ligament indentation; postoperative compression of the femoral head gradually swelling. CONCLUSION: The huge shunt, coarse round ligament, is one of the important pathological factors of femoral head necrosis after dislocation of the developmental dislocation of the hip. It should be identified by imaging examination before reduction as a contraindication to manual reduction.