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带血管蒂髂骨移植作为青少年髋关节半脱位髋臼增大术的一种方法。

Vascularised iliac graft as a method of acetabular augmentation in subluxed hip in adolescents.

作者信息

Fernandez-Palazzi Federico, Caviglia Horacio, Comando Daniel, Vizona Dalla Posta Daniel, Vallejos Nestor

机构信息

Pediatric and Neuro-orthopaedic Unit, Centro Médico de Caracas, Edif. Anexo B. Cons 4CAv. Juan de Villegas, San Bernardino, Caracas, 1011, Venezuela.

出版信息

Int Orthop. 2009 Feb;33(1):89-93. doi: 10.1007/s00264-008-0525-z. Epub 2008 Mar 7.

Abstract

This article presents the clinical experience of patients with a dysplasic subluxated hip treated with the same procedure involving a vascularised graft of iliac crest by sartorius muscle. This study was performed in three different centres, in two different countries, and in 31 patients with 37 hips (9 bilateral). All patients were clinically evaluated according to the Merle d Aubigne scale and radiological measuring of acetabular coverage, Sharp angle, and CE angle. Walking ability preoperatively was 4.87 and postoperatively 5.12, which was not statistically significant. Preoperative inclination acetabular angle was 59.0 degrees +/- 6.23 and postoperatively 37.5 degrees +/- 6.08 (P < 0.00001). Preoperative CE angle was -2.03 degrees +/- 13.5 and postoperatively was 41.0 degrees +/- 12.3 ( P < 0.00001). Index head acetabulum had a preoperative coverage of 48.3% +/- 13.0 and postoperatively 100.8% +/- 19.5. The head sphericity did not show any statistically significant difference in relation to the results. The results obtained were satisfactory from every point of view, making this the procedure of choice in the armamentarium to delay the need for a total joint as treatment of early osteoarthritis in young adults.

摘要

本文介绍了采用缝匠肌带血管蒂髂嵴移植相同手术治疗发育不良性髋关节半脱位患者的临床经验。本研究在两个不同国家的三个不同中心进行,纳入31例患者共37髋(9例双侧)。所有患者均根据Merle d'Aubigne量表进行临床评估,并对髋臼覆盖度、Sharp角和CE角进行影像学测量。术前步行能力评分为4.87,术后为5.12,差异无统计学意义。术前髋臼倾斜角为59.0°±6.23,术后为37.5°±6.08(P<0.00001)。术前CE角为-2.03°±13.5,术后为41.0°±12.3(P<0.00001)。股骨头髋臼指数术前覆盖度为48.3%±13.0,术后为100.8%±19.5。股骨头球形度与结果无统计学显著差异。从各方面来看,所获得的结果均令人满意,这使得该手术成为延缓年轻成人早期骨关节炎全关节置换需求的首选治疗方法。

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