Akazawa H, Tanabe G, Miyake Y
Department of Orthopaedic Surgery, Okayama University Medical School, Japan.
Acta Med Okayama. 1990 Aug;44(4):223-31. doi: 10.18926/AMO/30422.
Congenital hip dislocation, which is conservatively unmanageable, has usually been treated using open reduction. However, a long-term follow-up study of the results suggests that this procedure is unsatisfactory. Since 1973, Tanabe has used a new open reduction procedure that circumferentially dissects the joint capsule and produces sufficient concentric reduction of the femoral head in the acetabulum immediately after the surgery. Fifty-six children (65 hips) from the age of 1 to 3 years were treated by this procedure, and fifty-one of them were clinically and roentgenographically followed up from 6.3 to 12.4 years after the surgery. At the final follow-up session, all children had grown to be over 9 years of age, and no patient had clinically significant symptoms. According to Severin's classification, 33 hips were rated in Group I, and 14 hips in Group II. Another 10 hips were in Group III, and one hip was in Group IV. The incidence of avascular necrosis was 5.2 per cent. These data suggest that our procedure is more useful than the previous ones.
先天性髋关节脱位，保守治疗难以处理，通常采用切开复位治疗。然而，对该治疗结果的长期随访研究表明，这种手术并不令人满意。自1973年以来，田边采用了一种新的切开复位手术，该手术沿圆周方向切开关节囊，并在手术后立即使股骨头在髋臼内实现足够的同心复位。56名年龄在1至3岁的儿童（65个髋关节）接受了该手术治疗，其中51名在手术后6.3至12.4年进行了临床和X线随访。在最后一次随访时，所有儿童均已超过9岁，且无患者有临床显著症状。根据塞韦林分类法，33个髋关节被评为I组，14个髋关节被评为II组。另外10个髋关节为III组，1个髋关节为IV组。股骨头缺血性坏死的发生率为5.2%。这些数据表明我们的手术比以前的手术更有效。
