Sherk H H, Uppal G S, Lane G, Melchionni J
Division of Orthopaedic Surgery, Medical College of Pennsylvania, Philadelphia 19129.
Dev Med Child Neurol. 1991 Jun;33(6):491-4. doi: 10.1111/j.1469-8749.1991.tb14914.x.
Thirty myelomeningocele patients with untreated hip dislocations who had functional quadriceps and good ambulatory capability were evaluated for hip pain, hip motion and sitting ability: they had no pain, good to excellent hip motion and no difficulty in sitting. Three were wheelchair-bound. Nine had a limb-length inequality requiring a shoe lift. They were compared with a similar series of 11 patients who underwent open reduction of a dislocated hip with a two-year follow-up. Two patients in this group had improved and three had worse sitting balance. Serious perioperative complications occurred in six patients. The authors conclude that surgical reduction of paralytic hip dislocations in ambulatory myelomeningocele patients is costly and offers little obvious benefit.
对30例患有未经治疗的髋关节脱位的脊髓脊膜膨出患者进行了评估，这些患者股四头肌功能正常且具有良好的行走能力，评估内容包括髋关节疼痛、髋关节活动度和坐姿能力：他们没有疼痛，髋关节活动度良好至优秀，坐姿无困难。3例需要轮椅代步。9例存在肢体长度不等，需要使用增高鞋垫。将他们与另一组11例接受髋关节切开复位术且随访两年的类似患者进行比较。该组中有2例患者坐姿得到改善，3例患者坐姿平衡变差。6例患者出现了严重的围手术期并发症。作者得出结论，对于能行走的脊髓脊膜膨出患者，麻痹性髋关节脱位的手术复位成本高昂且益处不明显。
