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目的 对采用螺旋弹力牵引装置治疗先天性髋脱位 ,治疗后 10年以上的患者进行随访 ,探讨 X线结果、临床功能与治疗方式之间的关系 ,找出解决不同年龄 ,不同程度患儿的治疗方法及防止并发症出现的具体措施。方法 本组 138例共 15 8髋 ,复位时平均年龄为 2 2月 ,5 9髋单纯应用装置复位固定 ,6 4髋行内收肌、髂腰肌切断后应用装置复位成功 ,35髋采用 Ferguson’s术后安装装置。结果 平均随访 10年 6个月 ,随访时平均年龄 11.8岁。根据周永德评定标准 ,评定优良率为 91.1%。股骨头坏死率 5 .7%。结论 螺旋弹力牵引装置的牵引、自动复位功能减少了人为复位的创伤 ,提高了闭合复位的成功率。装置特定的外展角度及固定期间持续对抗髋周挛缩肌群的作用力 ,使头臼间压力减少 ,股骨头坏死率控制在 6 %以下 ,在保证复位稳定的前提下 ,动静结合使关节僵硬并发症降至 0
Objective To investigate the relationship between X-ray findings, clinical function and treatment modalities in patients with congenital dislocation of the hip treated with helical elastic traction device for more than 10 years after treatment, to find out the solution to the treatment of children of different ages and different degrees Methods and measures to prevent the emergence of complications. Methods A total of 138 hips were enrolled in this study. The average age at reset was 22 months. A total of 59 hips were treated with simple device fixation and 64 hips were adducted. The iliopsoas was resected and the device was successfully resected. The 35 hips were treated with Ferguson’s technique After installing the device. Results The average follow-up of 10 years and 6 months, mean age at follow-up was 11.8 years. According to Zhou Yongde assessment criteria, good rate was 91.1%. Femoral head necrosis rate of 5.7%. Conclusion The traction and automatic reduction of helical elastic traction device reduce the trauma of artificial reduction and improve the success rate of closed reduction. Device-specific abduction angle and sustained against the contracture of the hip muscle contracture muscle force, so that the pressure between the head and mortar decreased, the femoral head necrosis rate controlled at 6% or less, to ensure the stability of the reset under the premise of dynamic and static joint stiffness Complications dropped to zero