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目的探讨髋臼成形式骨盆截骨术治疗儿童先天性髋关节脱位的机制及临床疗效。方法 2011年1月-2015年7月广州中医药大学第一附属医院收治的19例先天性髋关节脱位患儿(21髋)为研究对象,采用髋臼成形式骨盆截骨术治疗。术前观察患者一般情况、基础疾病、CE角度、髋臼指数及股骨颈前倾角。术后观察植骨块及内固定情况、一般情况、基础疾病、CE角度、髋臼指数及股骨颈前倾角。结果全部患儿截骨有效及内固定全程稳定性,没有发生内固定失效和截骨端不愈合。15例(78.90%)患儿跛行明显改善,4例(21.10%)患儿跛行有改善。CE角度、髋臼指数及股骨颈前倾角均恢复正常,与手术前比较,差异均有统计学意义(均P<0.05)。术后复查植骨及大粗隆融合处均骨性愈合。结论髋臼成形式骨盆截骨术可以避免骨盆发育畸形,创伤及出血量小,可以更好地使髋臼向前外侧旋转,同时可以对髋臼穹窿塑形,使股骨头可以获得更佳的包容与覆盖,对CE角及髋臼指数有良好改善。
Objective To investigate the mechanism and clinical efficacy of acetabular pelvic osteotomy for the treatment of congenital dislocation of the hip in children. Methods From January 2011 to July 2015, 19 children with congenital dislocation of hip (21 hips) admitted to the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine were enrolled in this study. They were treated with acetabular pelvic osteotomy. Preoperative observation of the general situation of patients, basic diseases, CE angle, acetabular index and femoral neck anteversion. Postoperative bone graft and internal fixation, general conditions, underlying diseases, CE angle, acetabular index and femoral neck anteversion. Results All children were effective in osteotomy and full stability of internal fixation without internal fixation failure and nonunion of the osteotomy. Fifteen patients (78.90%) had a significant improvement of limpness, and four patients (21.10%) had limp limpness improved. CE angle, acetabular index and femoral neck anteversion were back to normal, compared with before surgery, the differences were statistically significant (P <0.05). Postoperative bone graft and greater trochanter fusion were bone healing. Conclusion The acetabular pelvic osteotomy can prevent pelvic deformity, reduce the trauma and blood loss, and can rotate the acetabulum to the anteromedial lateral. At the same time, it can shape the acetabulum and make the femoral head obtain better Inclusion and coverage, the CE angle and acetabular index have a good improvement.