摘要
目的评价分析发育性髋脱位闭合复位后出现股骨头缺血性坏死的影响因素。方法随访1995年1月至2001年12月采用内收肌切断、手法闭合复位、改良蛙式石膏固定方法治疗的有完整资料的6～36个月发育性髋脱位患者193例282髋，并对出现股骨头缺血性坏死并发症的10例10髋病例进行回顾性分析，比较其与复位前年龄、脱位程度、髋臼指数的关系。结果采用Salter评分标准，6～12个月组股骨头坏死2例，12～24个月组4例，24～36个月组4例。复位前髋臼指数值40。以上4例，40。以下6例。所有出现股骨头缺血性坏死的病例复位前髋关节都是Ⅲ度脱位。结论内收肌切断、手法闭合复位、改良蛙式石膏固定方法对6～36个月发育性髋脱位患者是一种有效的治疗方法，能很好的降低股骨头缺血性坏死的发生率，复位前髋臼指数值的大小与股骨头缺血性坏死的发生关系不大，但大于2cm的高度脱位是并发股骨头缺血性坏死的重要因素之一。
Objective To evaluate the factors of avascular necrosis after closed reduction of developmental dislocation of hip. Methods Follow up three groups of 193 children（282 hips） with DDH suffered from adductor tenotomy,closed reduction and frog type plaster immobilization process in 1995 to 2001. To study and research 10 hips with AVN after closed reduction completely and compare the relationship between AVN and AI,dislocation degree and age. Results According to the criteria of Salter,there are 2 hips with AVN in 6-12 months group and 4 hips in 12- 24 months group, 4 hips in 24- 36 months group. There are 4 hips appear AVN complication in more than 40°group of preoperative AⅠ and 6 hips in bellow 40°group. The dislocation degree of all the AVN hips are Ⅱ before treatment. Conclusion Adductor tenotomy,closed reduction and frog type plaster immobilization process is a effective way to treat children with DDH between 6-36 months old. The AVN incidence rate is very low in this treat system. There was no conspicuous relation between AVN and preoperative AI but the dislocation degree with more than 2 cm is a risk factor for AVN.
出处
《实用骨科杂志》
2009年第9期661-663,共3页
Journal of Practical Orthopaedics
关键词
缺血性坏死
发育性髋脱位
保守治疗
婴幼儿
avascular necrosis
developmental of dislocation hip
closed reduction
young children
