摘要
病例的手术治疗改进为了更好地解决小儿先天性髋关节脱位的髋臼狭窄，股骨头相对大的臼，头包容；为防止术后并发再脱位；减少股骨头缺血坏死；增加术后髋关节的稳定等问题。术式的方法在Ｐｅｍ ｂｅｒｔｏｎ 术式的基础上，在股骨头复位后用髋臼上方的髂骨外板形成骨瓣翻转覆盖股骨头以增加包容；髂骨截骨处的植骨块横形植入并以加宽的部分压在翻转的臼盖上增加其稳定度；为矫正股骨近段前倾角过大而作股骨上段截骨旋转的同时将远段截去１～１．５ｃｍ ，以减轻复位后的股骨头压力，又利用截下的股骨块切成四瓣嵌在髂骨植骨块的上面增加髂骨松质骨的强度。手术后结果，髋关节复位后很稳定；臼头包容增大；髋臼指数纠正在２０ 度内；未发生股骨头缺血坏死。随访结果髋关节功能恢复好，Ｔｒｅｎｄｅｌｅｎｂｕｒｇ 氏征阴性。因此，经改进后的手术方法对该病外科治疗的适应症，并发症增加了治疗手段。
This group of patients were treated with an operative method which was personaly designed on the basis of Pemberton method for settling following problems:narrow acetabulum can't enclose the big femoral head;high pressure leads to avascular necrosis of the femoral head and unstability of the hip causes dislocation again after operation.To deepen acetabulum,we turned over the external ilium lamina as a hinging graft coving on the femoral head when performing iliumotomy.At the iliumotomy,a dissociate cancellous bone was wadged on the plasted acetabulum for stabilizing it.For purpose of correcting the increased antervertion of upper end of the fematur,derotatively subtrochanteric osteotomy was neccessary and a 1～1.5cm long bone was excised and cut it into four grafts which were placed on the cancellous bone graft wadged on the turned acetabulum for increasing stiffeness.After this operation,the hip joint was more stable than befor and the acetabulum was big enough to enclose the femoral head.Minewhile,the configuration of acetabulum wasn't over twenty degreets and the avascular necrosis of femoral head didn't take place.The hip function was excellent and Trendelenburg sign elimilated.So,the improved operative method widened range of treatments for the indications and complications of congenital dislocation of hip in the surgery.
出处
《中国中医骨伤科》
CAS
1999年第5期16-18,共3页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
贵州省医药卫生科研项目
关键词
髋臼成形
先天性
髋关节脱位
儿童
Improved acetabuloplasty Congenital dislocation of hip
