Noonan K J, Walker T L, Kayes K J, Feinberg J
Department of Orthopaedics, Riley Children's Hospital, Indianapolis, Indiana 46202, USA.
J Pediatr Orthop. 2000 Nov-Dec;20(6):771-5. doi: 10.1097/00004694-200011000-00014.
We studied the fate of the nonoperated hip in 35 patients with cerebral palsy who underwent surgical stabilization for unilateral hip subluxation (24 patients) or dislocation (11 patients). Review of medical records and radiographs was performed and analysis was accomplished on the effect of preoperative and radiographic variables on the radiographic outcome of the nonoperated hip. The average age at surgery was 5.5 years and at follow-up was 9.7 years, with an average follow-up of 4.2 years. Before subsequent surgery (in 15 nonoperated hips) or at follow-up, 10 of the nonoperated hips were dislocated and 16 hips were subluxated. Hips were stable and less likely to have surgery if they had a lower initial migration index and higher center edge angles. We conclude that there are few indications for unilateral hip surgery in patients with diplegia or quadriplegia undergoing initial hip stabilization surgery, especially if any degree of dysplasia is present.
我们研究了35例因单侧髋关节半脱位（24例）或脱位（11例）而接受手术稳定治疗的脑瘫患者中未手术髋关节的转归情况。对病历和X线片进行了回顾，并分析了术前和影像学变量对未手术髋关节影像学结果的影响。手术时的平均年龄为5.5岁，随访时为9.7岁，平均随访4.2年。在后续手术前（15个未手术髋关节）或随访时，10个未手术髋关节发生脱位，16个髋关节半脱位。如果初始移位指数较低且中心边缘角较高，髋关节则较为稳定，且进行手术的可能性较小。我们得出结论，对于接受初次髋关节稳定手术的双瘫或四肢瘫患者，尤其是存在任何程度发育不良的患者，单侧髋关节手术的指征很少。
