Wu Hongfei, Liang Xibin, Zhao Wei, Guo Baofeng, Ren Longxi, Qin Sihe, Chen Jianwen, Peng Aimin, Yang Huaqing
Department of Orthopaedics, ChuiYangLiu Hospital Affiliated to Tsinghua University, Beijing, 100022, P.R.China.
Department of Orthopaedics, ChuiYangLiu Hospital Affiliated to Tsinghua University, Beijing, 100022,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Nov 15;33(11):1379-1383. doi: 10.7507/1002-1892.201904107.
To evaluate the effectiveness of modified Ilizarov hip reconstruction in the treatment of hip instability.
The clinical data of 13 young patients with hip diseases treated with modified Ilizarov hip reconstruction between January 2010 and March 2018 were retrospectively analyzed. There were 2 males and 11 females, aged from 14 to 34 years, with an average age of 24.2 years. There were 1 case of hip dysplasia and dislocation due to spinal bifida, 3 cases of hip dysplasia after pyogenic arthritis of the hip, 2 cases of developmental dysplasiaof the hip (DDH) accompanying femoral head necrosis who rejected hip replacement, 6 cases of young DDH refused to undergo hip replacement, and 1 case of bilateral hip dysplasia with dislocation due to sputum cerebral palsy. The disease duration was 2-20 years, with an average of 8.5 years. Preoperative Trendelenburg sign was positive in 12 cases and negative in 1 case. The preoperative Harris score of hip joint was 53.5±8.9 and the unequal length of lower limbs was (46.08±15.73) mm. Postoperative Harris hip score and patients' satisfaction with effectiveness evaluated according to their self scoring were used to assess the effectiveness.
All 13 patients were followed up 1-5 years, with an average of 2.6 years. Five patients developed postoperative needle infection, which improved after dressing change; 7 patients had limited knee joint activity and improved after knee joint function training. The Trendelenburg sign was negative at 1 year after operation, and the patient's hip pain symptoms were relieved or disappeared. The Harris hip score of patients at 1 year after operation was 84.5±6.1, which was significantly improved when compared with preoperative one ( =－10.538, =0.000). According to Harris hip score, the effectiveness results were excellent in 4 cases, good in 5 cases, and fair in 4 cases, with an excellent and good rate of 69.2%. The unequal length of lower limbs was (15.38±7.27) mm, which was significantly better than that before operation ( =11.826, =0.000). At last follow-up, the patients' satisfaction score was 80%-95%, with an average of 88%.
Modified Ilizarov hip reconstruction can be used to treat young patients with hip disease who are unsuitable or refuse to undergo artificial hip replacement. Its effectiveness is reliable, and it has unique advantages in limb limp improvement and limb shortening correction.
评估改良伊利扎洛夫髋关节重建术治疗髋关节不稳的有效性。
回顾性分析2010年1月至2018年3月采用改良伊利扎洛夫髋关节重建术治疗的13例年轻髋关节疾病患者的临床资料。其中男性2例，女性11例，年龄14～34岁，平均24.2岁。病因包括脊柱裂致髋关节发育不良并脱位1例，化脓性髋关节炎后髋关节发育不良3例，发育性髋关节发育不良（DDH）伴股骨头坏死拒绝行髋关节置换术2例，年轻DDH拒绝行髋关节置换术6例，脑瘫致双侧髋关节发育不良并脱位1例。病程2～20年，平均8.5年。术前Trendelenburg征阳性12例，阴性1例。术前髋关节Harris评分为53.5±8.9分，双下肢不等长为（46.08±15.73）mm。以术后Harris髋关节评分及患者根据自我评分评估的疗效满意度来评价疗效。
13例患者均获随访1～5年，平均2.6年。术后5例出现针道感染，经换药后好转；7例膝关节活动受限，经膝关节功能训练后好转。术后1年Trendelenburg征阴性，患者髋关节疼痛症状缓解或消失。术后1年患者Harris髋关节评分为84.5±6.1分，与术前比较差异有统计学意义（ =－10.538， =0.000）。根据Harris髋关节评分，疗效优4例，良5例，可4例，优良率为69.2%。双下肢不等长为（15.38±7.27）mm，明显优于术前（ =11.826， =0.000）。末次随访时，患者满意度评分为80%～95%，平均88%。
改良伊利扎洛夫髋关节重建术可用于治疗不适合或拒绝行人工髋关节置换术的年轻髋关节疾病患者。其疗效可靠，在改善肢体跛行及矫正肢体短缩方面具有独特优势。
