Yin Shijiu, Li Ruibo, Mou Ping, Zhong Hang, Yang Jing
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Apr 15;32(4):385-388. doi: 10.7507/1002-1892.201711053.
To explore the mid-term effectiveness of total hip arthroplasty (THA) with subtrochanteric shortening osteotomy in treatment of Crowe type Ⅳ developmental dysplasia of the hip (DDH).
Between September 2009 and March 2014, a total of 49 patients (57 hips) who were diagnosed with Crowe type Ⅳ DDH were treated with THA and subtrochanteric shortening osteotomy. Of the 49 patients, 7 were male and 42 were female with an average age of 44.6 years (range, 20-73 years). The preoperative Harris score was 44.68±3.39 and the preoperative leg length discrepancy was (5.27±0.55) cm.
All incisions healed primarily. All patients were followed up 32-87 months (mean, 52.1 months). At last follow-up, the Harris score was 85.67±2.89 and the leg length discrepancy was (1.12±0.48) cm, showing significant differences when compared with the preoperative values ( =-69.53, =0.00; =42.94, =0.00). X-ray films showed that bone union of the femoral osteotomy end at 6 months after operation. There was no loosening and subsidence of prosthesis at last follow-up.
The subtrochanteric shortening osteotomy with THA in treatment of Crowe type Ⅳ DDH can obtain satisfactory mid-term effectiveness with low risk of peripheral vascular and nerve traction injuries.
探讨转子下短缩截骨全髋关节置换术(THA)治疗CroweⅣ型发育性髋关节发育不良(DDH)的中期疗效。
2009年9月至2014年3月,共49例(57髋)诊断为CroweⅣ型DDH的患者接受了THA联合转子下短缩截骨治疗。49例患者中,男性7例,女性42例,平均年龄44.6岁(范围20 - 73岁)。术前Harris评分为44.68±3.39,术前双下肢长度差为(5.27±0.55)cm。
所有切口均一期愈合。所有患者均获随访32 - 87个月(平均52.1个月)。末次随访时,Harris评分为85.67±2.89,双下肢长度差为(1.12±0.48)cm,与术前值比较差异有统计学意义(=-69.53,=0.00;=42.94,=0.00)。X线片显示术后6个月股骨截骨端骨愈合。末次随访时假体无松动及下沉。
转子下短缩截骨联合THA治疗CroweⅣ型DDH可获得满意的中期疗效,且周围血管及神经牵拉伤风险低。