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大龄儿童发育性髋关节脱位的一期联合手术(无论是否进行术前牵引)

One-stage combined surgery with or without preoperative traction for developmental dislocation of the hip in older children.

作者信息

Tezeren G, Tukenmez M, Bulut O, Cekin T, Percin S

机构信息

Department of Orthopaedics and Traumatology, School of Medicine, Cumhuriyet University, Sivas, Turkey.

出版信息

J Orthop Surg (Hong Kong). 2006 Dec;14(3):259-64. doi: 10.1177/230949900601400306.

Abstract

PURPOSE

To compare one-stage combined surgery with and without preoperative traction, in older children with developmental dislocation of the hip (DDH).

METHODS

Records of 9 children who underwent combined surgery for DDH with preoperative traction in 12 hips (group 1) and 12 undergoing the same procedure without preoperative traction in 16 hips (group 2) were retrospectively reviewed. The surgery consisted of open reduction, Salter's innominate osteotomy and femoral shortening with derotation varus osteotomy. The mean age of the patients at the time of operation was 5.8 years. The mean follow-up period was 5.9 years.

RESULTS

At final follow-up, clinical outcome in group 1 was worse than that in group 2, though radiographic assessment demonstrated no significant difference between the groups.

CONCLUSION

One-stage combined surgery without preoperative traction is effective in the treatment of DDH in older children, and has a lower complication rate, but radiographically the groups did not differ.

摘要

目的

比较一期联合手术在有或无术前牵引情况下,用于大龄发育性髋关节脱位(DDH)患儿的治疗效果。

方法

回顾性分析9例接受DDH联合手术且术前对12个髋关节进行牵引的患儿(第1组)以及12例接受相同手术但未进行术前牵引的16个髋关节患儿(第2组)的记录。手术包括切开复位、Salter骨盆截骨术以及股骨缩短内旋内收截骨术。手术时患者的平均年龄为5.8岁。平均随访期为5.9年。

结果

末次随访时,第1组的临床结果比第2组差,尽管影像学评估显示两组之间无显著差异。

结论

一期联合手术不进行术前牵引对大龄儿童DDH的治疗有效,且并发症发生率较低,但影像学上两组无差异。

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