Park Jong-Seok, Kim Woo-Jong, Lee Dhong-Won, Soh Jae-Wan, Won Sung-Hun, Lee Sang-Woo, Moon Sang-Il, Kim Hyoung-Ye
Department of Orthopaedic Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Department of Orthopaedic Surgery, KonKuk University Medical Center, Seoul, Korea.
Hip Pelvis. 2017 Sep;29(3):187-193. doi: 10.5371/hp.2017.29.3.187. Epub 2017 Sep 6.
The purpose of this study is to present the effective design of N-plasty of the iliotibial band and surgical results of its use as a treatment for refractory external snapping hip.
We evaluated 17 patients (24 cases) with external snapping hip who underwent N-plasty between October 2013 and May 2016 and who were followed up for at least 12 months. All patients were male and the mean age was 20.8 years. The mean duration of symptoms prior to surgical intervention was 28.5 months with an average follow up of 24.5 months. Surgery was defined as being successful when patients could carry out their daily activities and exercise without a clicking sensation or pain 6 months after surgery until their last follow-up. Failure was defined when either a clicking sensation or pain was present. The visual analog scale (VAS) and modified Harris hip score (mHHS) were measured and compared preoperatively and at last follow-up.
All patients had complete resolution of pain and snapping. The VAS decreased from 6.77 preoperatively to 0.09 postoperatively and mHHS improved from 69.5 to 97.8 after surgery.
Modified designed N-plasty is considered to be an excellent treatment method facilitating operation reproducibility with maximum elongation effect of the iliotibial band.
本研究旨在介绍髂胫束N成形术的有效设计及其作为难治性外侧弹响髋治疗方法的手术效果。
我们评估了2013年10月至2016年5月期间接受N成形术并至少随访12个月的17例（24髋）外侧弹响髋患者。所有患者均为男性，平均年龄20.8岁。手术干预前症状的平均持续时间为28.5个月，平均随访时间为24.5个月。若患者在术后6个月直至最后一次随访时能够在无弹响感或疼痛的情况下进行日常活动和锻炼，则手术定义为成功。若存在弹响感或疼痛，则定义为失败。术前及最后一次随访时测量并比较视觉模拟评分（VAS）和改良Harris髋关节评分（mHHS）。
所有患者的疼痛和弹响均完全消失。VAS从术前的6.77降至术后的0.09，mHHS从术前的69.5提高至术后的97.8。
改良设计的N成形术被认为是一种出色的治疗方法，可提高手术的可重复性，并使髂胫束获得最大程度的延长效果。
