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目的观察Salter截骨术治疗发育性髋关节脱位的临床疗效。方法对25例发育性髋关节脱位患儿采用常规Smith-Peterson切口,从同侧髂前上、下棘之间向坐骨大切迹截骨,在距离髂前上棘后方2.5cm左右处凿切长为3cm、30°左右的三角形骨块,将植骨块楔形嵌入,然后用2枚克氏针从髂前上棘偏后穿绕固定。再同心圆中心复位髋臼后缝合关节囊。术后患肢予以改良贝氏石膏固定5周左右。术后均随访2年,记录髋关节功能和髋臼覆盖股骨头的百分比、髋臼指数以及CE角。结果 25例患儿术后随访时间均为2年,参照McKay髋关节评定标准以及Severin标准进行评定,优良率达96%。25例患儿术后X线片检查髋臼角为22°-27°,平均23±4°,平均纠正髋臼角15±5°;CE角为35°-43°,平均39.12±5.48°;髋臼覆盖股骨头的百分比为96.5%-118.9%,平均106.1±10.95%。与术前比较,P<0.05,各组差异均有显著性意义。结论 Salter截骨术适合于治疗1.5-6岁、髋臼指数<45°,且股骨头大小与髋臼基本适应的发育性髋关节脱位患儿可使股骨头达到中心复位,恢复良好的髋关节功能,临床效果满意。
Objective To observe the clinical effect of Salter osteotomy in the treatment of developmental dislocation of the hip. Methods 25 cases of children with developmental dislocation of hip joint using conventional Smith-Peterson incision from the ipsilateral anterior superior iliac spine to the greater sciatic bone between the cut, in the distance from the anterior superior iliac spine about 2.5cm behind chisel cut long For the 3cm, 30 ° triangular bone, the bone graft wedge embedded, and then use two Kirschner wire from the anterior superior iliac spine after the wound wear fixed. Re-concentric center reset the acetabulum suture joint capsule. Postoperative limbs to be modified Bayesian plaster fixed for about 5 weeks. All patients were followed up for 2 years. The function of hip joint, the percentage of femoral head covered by acetabulum, acetabular index and CE angle were recorded. Results All the 25 cases were followed up for 2 years. According to McKay hip joint evaluation criteria and Severin criteria, the excellent and good rate was 96%. In 25 cases, the acetabulum angle was 22 ° -27 ° (average 23 ± 4 °) and the mean angle of acetabulum was 15 ± 5 °. The CE angle was 35 ° -43 ° with an average of 39.12 ± 5.48 ° ; Acetabular cover the percentage of femoral head was 96.5% -118.9%, an average of 106.1 ± 10.95%. Compared with the preoperative, P <0.05, the differences between the groups were significant. Conclusion Salter osteotomy is suitable for the treatment of 1.5-6 years old, acetabular index <45 °, and the basic adaptation of the femoral head size and acetabular development of children with hip dislocation can make the femoral head to the center of the reduction, the recovery of the hip Function, clinical results satisfactory.