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采用股骨远端缩短的非骨水泥型关节置换术治疗Crowe IV型发育性髋关节发育不良。

Cementless arthroplasty with a distal femoral shortening for the treatment of Crowe type IV developmental hip dysplasia.

作者信息

Guo Chang-Yong, Liang Bo-Wei, Sha Mo, Kang Liang-Qi, Wang Jiang-Ze, Ding Zhen-Qi

机构信息

Department of Orthopaedics, The Affiliated Southeast Hospital of Xiamen University, Orthopaedic Center of the People's Liberation Army, Zhangzhou 363000, China.

出版信息

Indian J Orthop. 2015 Jul-Aug;49(4):442-6. doi: 10.4103/0019-5413.159652.

Abstract

BACKGROUND

Severe developmental dysplasia of the hip is a surgical challenge. The purpose of this study is to describe the cementless arthroplasty with a distal femoral shortening osteotomy for Crowe type IV developmental hip dysplasia and to report the results of this technique.

MATERIALS AND METHODS

12 patients (2 male and 10 female) of Crowe type IV developmental hip dysplasia operated between January 2005 and December 2010 were included in the study. All had undergone cementless arthroplasty with a distal femoral shortening osteotomy. Acetabular cup was placed at the level of the anatomical position in all the hips. The clinical outcomes were assessed and radiographs were reviewed to evaluate treatment effects.

RESULTS

The mean followup for the 12 hips was 52 months (range 36-82 months). The mean Harris hip score improved from 41 points (range 28-54) preoperatively to 85 points (range 79-92) at the final followup. The mean length of bone removed was 30 mm (range 25-40 mm). All the osteotomies healed in a mean time of 13 weeks (range 10-16 weeks). There were no neurovascular injuries, pulmonary embolism or no infections.

CONCLUSION

Our study suggests that cementless arthroplasty with a distal femoral shortening is a safe and effective procedure for severe developmental dysplasia of the hip.

摘要

背景

重度发育性髋关节发育不良是一项手术挑战。本研究的目的是描述采用股骨远端缩短截骨术的非骨水泥型关节置换术治疗Crowe IV型发育性髋关节发育不良,并报告该技术的结果。

材料与方法

本研究纳入了2005年1月至2010年12月间接受手术的12例(2例男性,10例女性)Crowe IV型发育性髋关节发育不良患者。所有患者均接受了股骨远端缩短截骨术的非骨水泥型关节置换术。所有髋关节的髋臼杯均放置在解剖位置水平。评估临床结果并复查X线片以评估治疗效果。

结果

12个髋关节的平均随访时间为52个月(范围36 - 82个月)。Harris髋关节平均评分从术前的41分(范围28 - 54分)提高到末次随访时的85分(范围79 - 92分)。平均截骨长度为30 mm(范围25 - 40 mm)。所有截骨均在平均13周(范围10 - 16周)内愈合。未发生神经血管损伤、肺栓塞或感染。

结论

我们的研究表明,股骨远端缩短的非骨水泥型关节置换术是治疗重度发育性髋关节发育不良的一种安全有效的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a1b/4510799/99a054477bdb/IJOrtho-49-442-g001.jpg

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