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目的探讨发育性髋脱位并关节松弛症患儿术后渐发半脱位的原因及对策。方法笔者自2005-02—2015-03对13例小儿发育性髋脱位并关节松弛症采用切开复位、Salter骨盆截骨、股骨近端短缩旋转截骨术治疗,于术后即刻、8周、12周、24周、36周对髋臼指数、CE角沈通氏线、泪滴是否出现、髋臼眉弓是否出现等指标进行比较,确定髋关节是否稳定复位。结果术后12周髋关节出现半脱位,通过外展支具后24周髋关节获得稳定复位。结论由于关节囊松弛,失去髋脱位术后早期对复位股骨头的固定作用,早期头臼尚不匹配,故出现半脱位;此类患儿术后髋关节的稳定复位主要依靠头臼骨性匹配,外展支具能有效矫正半脱位,促进髋关节同心骨性重塑。
Objective To investigate the causes and strategies of progressive subluxation in children with developmental dislocation of the hip and joint relaxation. Methods The author from 2005-02-2015-03 13 cases of pediatric developmental dislocation of the hip and joint relaxation syndrome using open reduction, Salter pelvic osteotomy, short proximal femur rotation osteotomy, at the immediate postoperative, 8 weeks , 12 weeks, 24 weeks, 36 weeks, the acetabular index, CE angle Shen Tong line, the presence of teardrops, acetabular eyebrows and other indicators were compared to determine whether the hip joint stable reset. Results Twelve weeks after operation, the hip joint appeared subluxation, and stable reduction was achieved at the hip joint 24 weeks after the outreach brace. Conclusions Due to the loose joint capsule and the early fixation of the displaced femoral head after the dislocation of the hip joint, the dislocations of the first acetabular head are not matched in the early stage. The stable reduction of the hip joint in these children mainly depends on the bones of the acetabulum Outreach brace can effectively correct subluxation and promote concentric bony remodeling of the hip.