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目的观察婴儿期行转子关节成形术治疗股骨头缺如伴病理性髋关节脱位的远期疗效。方法对 18例年龄为 11～ 30个月，平均 18.2个月、股骨头缺如伴病理性髋关节脱位患儿施行转子关节成形术，随访 5～ 16年，平均 9.25年。术前根据 Hunka X线检查方法进行病理分型 :Ⅰ型 1例、Ⅱ型 2例、Ⅴ型 15例。结果 18例中优 8例，股骨近端形态及髋关节功能接近正常，肢体平均短缩 0.25 cm；良 3例，股骨头近似球形、无颈，功能尚好，肢体平均短缩 1.5 cm；可 5例，股骨近端塑形不尽理想，髋臼覆盖不良，肢体平均短缩 2.1 cm，需再次手术治疗；差 2例，再脱位。结论在婴儿期施行转子关节成形术是治疗股骨头缺如的最佳时机，此时患儿骨组织具有较强的塑形能力，术后髋关节功能恢复良好，且可防止肢体短缩畸形。
Objective To observe the long-term effect of neonatal arthroplasty in the treatment of femoral head abnormity with pathological hip dislocation. Methods 18 cases of children aged 11 to 30 months with an average of 18.2 months were enrolled in this study. The patients were followed up for 5 to 16 years (average 9.55 years) with rotatorodial arthroplasty for femoral head absent patients with pathological hip dislocation. According to the Hunka X-ray examination, 1 case was type Ⅰ, 2 cases type Ⅱ and 15 cases type Ⅴ. Results Among 18 cases, 8 cases were excellent, the shape of proximal femur and the function of hip joint were close to normal. The limbs were shortened by 0.25 cm in average. The femoral head was nearly spherical with no neck and had good function. For example, the proximal femur not ideal shape, poor acetabular cover, the average body shortening 2.1 cm, need reoperation; poor in 2 cases, and then dislocation. Conclusion Rotor arthroplasty in infancy is the best time to treat femoral head absent. At this time, the bone tissue of the patient has a strong ability of shaping and the function of the hip joint is recovered well after operation, and the limb shortening deformity can be prevented.