摘要
[目的]探讨不同年龄组大龄发育性髋关节脱位(developmental dysplasia of the hip,DDH)患儿的手术治疗效果。[方法]2006年11月~2014年6月采用髋关节切开复位,骨盆Pemberton、Dega髋臼成形或三联截骨,股骨旋转短缩截骨结合内收肌切断等手术一期治疗大龄儿童DDH 91例(104髋),按年龄情况将患儿分为两组:低龄组(<10岁):61例(70髋),年龄6~9.8岁,平均7.9岁。高龄组(≥10岁):30例(34髋),年龄10~15岁,平均12.5岁。[结果]91例术后均获得随访,随访时间2~8年,根据Severin影像学评价标准,低龄组:Pemberton术后优良率91.43%,Dega术后优良率85.71%,骨盆三联截骨术后优良率85.71%;高龄组:Pemberton术后优良率58.33%,Dega术后优良率50.00%,骨盆三联截骨术后优良率40.00%。根据Mckay临床评价标准,低龄组:Pemberton术后优良率88.57%,Dega术后优良率85.71%,骨盆三联截骨术后优良率85.71%;高龄组:Pemberton术后优良率58.33%,Dega术后优良率41.67%,骨盆三联截骨术后优良率40.00%。[结论]本研究针对6岁以上大龄DDH患儿的手术疗效进行随访,发现大龄DDH是可以选择性的通过手术治疗的,同时通过比较两组患儿手术疗效的差异,发现低龄组的术后临床及影像学优良率均高于高龄组,提示DDH患儿需要早期手术改善头臼覆盖关系,才有可能获得较好的临床效果。
[Objective] To investigate and compare the surgical outcomes of delayed diagnosed developmental dysplesia of the hip （DDH） in different age groups of children. [Methods] From November 2006 to June 2014, 53 patients （61 hips） with delayed diagnosed DDH were treated with Pemberton, Dega, and triple innominate esteotomy by S-P approach, and the clinical data were retrospectively analyzed. There were 9 males and 44 females with an average age of 8.8 years ranged from 6 to 15 years. Of them, 37 children （45 hips） were divided into the 〈10 years group and 16 children （16 hips） were enrolled into the ≥10 years group. The patients in the 〈10 years group received Pemberton osteotomy （n=29, 35 hips）, Dega osteotomy （n=6, 8 hips）, and triple innominate osteotomy （n=2, 2 hips）, respectively. While patients in the 310 years group underwent Pemberton osteotomy （n=3, 3 hips）, Dega osteotomy （n=7, 7 hips）, and triple innominate osteotomy （n=6, 6 hips）, respectively. [Results] The patients were followed up for 2 to 8 years with a mean of 7,9 years. According to the Severin radiographic criteria, the excellent and good outcomes in the 〈10 years group were achieved in 91.43% of Pemberton osteotomy （32/35）, 100.00% of Dega esteotomy （8/8）, 100% of triple irmominate osteotomy （2/2）, whereas the rate in the 310 years group was 66.67% of Pemberton osteotomy （2/3）, 71.43% of Dega osteotomy （5/7）, 66.67% of triple innominate osteotomy （4/6） , respectively. In addition, based on Mckay clinical criteria, the 〈10 years group had excellent and good outcomes in 91.43% of Pemberton osteotomy （32/35）, 87.50% ofDega osteotomy （7/8）, 100.00% of triple innominate osteotomy （2/2）, while the 310 years group got that results in 66.7% of Pemberton osteotomy （2/3）, 57.14% of Dega osteotomy （4/7）, and 66.67% of triple innominate osteotomy （3/6）, respectively. [Conclusion] Although delayed diagnosed DDH could still be treated surgically, taking surgical treatment as early as possible ix still the cornerstone to obtain better clinical results.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2017年第9期775-780,共6页
Orthopedic Journal of China
基金
国家自然科学基金项目(编号:81171735)
关键词
发育性髋关节脱位
大龄儿童
手术疗效
developmental dislocation of the hip, delayed diagnosis, surgical treatment
