Raimann A, Saavedra C, Améstica G, De la Fuente M
Orthopädische Klinik des Krankenhauses Paula Jaraquemada, Santiago, Chile.
Z Orthop Ihre Grenzgeb. 1988 Mar-Apr;126(2):161-8. doi: 10.1055/s-2008-1044887.
166 patients with congenital dislocation of the hip, ranging from 10 months to 5 years old, were operated between 1958 and 1971. 140 patients were women (84%) and 26 patients were men (16%). 96 patients had unilateral and 70 patients had bilateral dislocation; that makes a total of 236 dislocated hips. 61 patients with bilateral hip dislocation were operated simultaneously on both hips. All the patients were treated with adductor tenotomy and open reduction through Smith Petersen incision with section or elongation of the psoas tendon. The postoperative immobilization consisted in a period of one month pelvic toecast followed by 2 plaster casts with abduction rod during 3 to 5 months. The postoperatory follow-up ranged from 9 years to 26 years, 2 months; average 14 years, 5 months. The clinical evaluation comprises pain, hip mobility, gait and muscle power.
excellent 138 (59%); good 66 (28%); fair 29 (12%); and poor 3 (1%). The radiological evaluation considered: Mose; acetabular femoral head index; Wiberg's CD-angle; cervico-diaphysiary angle and radial quotient.
normal 5 (2%); excellent 44 (19%); good 78 (33%); subtotal 54%; fair 90 (38%), and poor 19 (8%). Complications (hips); infections 12 (5%); 3 of them deep ones (1%); residual subluxation 19 (8%); reluxation 1 (0.5%). Isquemic necrosis Grade II of Tönnis 31 (13%); Grade III 2 (1%) and Grade IV 1 (0.5%).
1958年至1971年间,对166例年龄在10个月至5岁之间的先天性髋关节脱位患者进行了手术。其中女性140例(84%),男性26例(16%)。单侧脱位96例,双侧脱位70例;共计236个脱位髋关节。61例双侧髋关节脱位患者同时对双侧髋关节进行了手术。所有患者均接受内收肌切断术,并通过史密斯 - 彼得森切口进行切开复位,同时切断或延长腰大肌腱。术后固定包括1个月的骨盆足趾石膏固定,随后在3至5个月内使用带外展杆的2个石膏固定。术后随访时间为9年至26年2个月,平均14年5个月。临床评估包括疼痛、髋关节活动度、步态和肌肉力量。
优138例(59%);良66例(28%);可29例(12%);差3例(1%)。放射学评估指标包括:莫斯;髋臼股骨头指数;维伯格CD角;头颈干角和径向商。
正常5例(2%);优44例(19%);良78例(33%);小计54%;可90例(38%),差19例(8%)。并发症(髋关节):感染12例(5%);其中深部感染3例(1%);残余半脱位19例(8%);再脱位1例(0.5%)。托尼斯Ⅱ级缺血性坏死31例(13%);Ⅲ级2例(1%),Ⅳ级1例(0.5%)。