摘要
目的对成人髋发育不良行Chiari截骨术进行远期随访,评估该治疗方法的有效性。方法对接受Chiari截骨术治疗的病人,分别测定其术前和术后JOA评分、中心边缘角和Sharp角、术后截骨远端内移率和截骨平面的高度,并对影响结果的因素进行相关性分析。结果平均随访时间为128年,病人38例,共45侧髋,其中男3例,女35例,手术时平均年龄为385岁。45侧髋中,有17例髋关节骨性关节炎得到明显改善,占377%;有13侧髋关节骨性关节炎无明显变化,占289%;有15侧髋关节骨性关节炎病变继续恶化,占333%。术前JOA平均为599分,术后838分。术后疗效为优占370%,良占342%,一般占155%,差占133%。术前平均中心边缘角-115°,术后为246°。术前平均Sharp角为544°,术后平均为433°。平均截骨角度为751°,股骨头顶点至截骨平面的距离平均为817mm。截骨远端内移率平均值为336%。结论经过10年以上的随访表明,Chiari截骨术能使成人髋发育不良的疼痛症状得到缓解,一部分病人骨性关节炎的过程得到有效的遏制。
Objective:To observe the long term result of Chiari osteotomy in adult patients with developmental hip dysplasia and evaluate its efficacy Method:Among the adult patients with developmental hip dysplasia who received Chiari osteotomy,pre and postoperative JOA scores,CE angle and Sharp angle were measured The displacement rate of osteotomy,the osteotomy height and the inclination angle were evaluated postoperatively These parameters were correlated with the factors which may influence the final result Result:The mean duration of follow up were 12 8 years In total,among 38 patients(45 hips),35 were females and 3 males The averaged age at the operation were 38 5 years Among the 45 hips,in 17 hips(37 7%)there were evident improvement;in 15 hips(33 3%),the deterioration of osteoarthritis was found Preoperative JOA scores averaged 59 9 points while postoperative ones 83 8 points Thirty seven percent of the affected hips had excellent result,34 2% good,15 5% fair and 13 3% poor The mean of CE angle were 11 5°preoperatively and 24 6°postoperatively Pre and postoperative mean Sharp angles were 54 4°and 43 3°respectively The mean osteotomy angle was 7 51° The osteotomy height averaged 8 17mm The mean displacement rate was 33 6% Conclusion:The long term follow up with the duration of more than 10 years shows that Chiari osteotomy can release the symptoms of pain in adult patients with developmental hip dysplasia and arrest effectively the advancement of osteoarthritis in some patients
出处
《中国矫形外科杂志》
CAS
CSCD
2004年第21期1620-1622,共3页
Orthopedic Journal of China
