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门诊髋关节残留发育性发育不良患儿的微创德加截骨术——技术与前瞻性病例系列

Minimally-Invasive Dega Osteotomy in Ambulatory Pediatric Patients With Residual Developmental Dysplasia of the Hips-A Technique and Prospective Case Series.

作者信息

AlSaifi Saleh, Lari Ali

机构信息

From the Department of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait.

出版信息

J Am Acad Orthop Surg Glob Res Rev. 2025 May 22;9(6). doi: 10.5435/JAAOSGlobal-D-25-00023. eCollection 2025 Jun 1.

DOI:10.5435/JAAOSGlobal-D-25-00023
PMID:40456044
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12107525/
Abstract

PURPOSE

This study describes the minimally invasive Dega osteotomy for treating residual acetabular dysplasia in ambulatory pediatric patients. The focus is on assessing the safety, feasibility, and early outcomes of this minimally invasive technique.

METHODS

A prospective series was conducted in a single tertiary orthopaedic center. The procedure involved an initial examination of hip joint stability using intraoperative arthrography. The surgical procedure involved a small transverse incision distal and lateral to the anterior superior iliac spine, followed by a Dega osteotomy and bone allografting. Variables such as surgical time, blood loss, incision length, and acetabular index were measured.

RESULTS

In healthy ambulatory patients, 16 osteotomies were performed on 12 patients with an average age of 32 months. The mean incision length was 2.3 cm, average blood loss was 17 mL, and mean surgical time was 21 minutes per side. Preoperative and postoperative acetabular indices averaged 40.3° and 18.6°, respectively. The mean follow-up period was 13 months. No complications were seen in this series.

CONCLUSION

The minimally invasive Dega osteotomy technique is a safe and effective method for treating residual acetabular dysplasia in ambulatory patients. It offers advantages of minimal invasiveness, reduced surgical time, and less blood loss, with outcomes comparable to standard methods. However, further studies with larger cohorts and longer follow-up are necessary to fully establish its efficacy and safety profile.

摘要

目的

本研究描述了用于治疗能行走的儿科患者残余髋臼发育不良的微创德加截骨术。重点在于评估这种微创技术的安全性、可行性和早期疗效。

方法

在一家单一的三级骨科中心进行了一项前瞻性系列研究。该手术包括术中关节造影对髋关节稳定性进行初步检查。手术过程包括在髂前上棘远端和外侧做一个小的横向切口,随后进行德加截骨术和骨移植。测量了手术时间、失血量、切口长度和髋臼指数等变量。

结果

在健康能行走的患者中,对12例平均年龄32个月的患者进行了16次截骨术。平均切口长度为2.3厘米,平均失血量为17毫升,每侧平均手术时间为21分钟。术前和术后髋臼指数分别平均为40.3°和18.6°。平均随访期为13个月。本系列中未观察到并发症。

结论

微创德加截骨术是治疗能行走患者残余髋臼发育不良的一种安全有效的方法。它具有微创、手术时间缩短和失血量减少的优点,疗效与标准方法相当。然而,需要进行更大样本量和更长随访期的进一步研究,以充分确立其疗效和安全性。

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J Orthop Traumatol. 2023 Aug 17;24(1):43. doi: 10.1186/s10195-023-00725-3.
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Research on anterior minimally invasive approach in the treatment of children with developmental dysplasia of the hip.发育性髋关节发育不良儿童前微创入路治疗的研究。
BMC Musculoskelet Disord. 2023 Jun 13;24(1):482. doi: 10.1186/s12891-023-06582-9.
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Outcomes of Open Reduction in Children With Developmental Hip Dislocation: A Multicenter Experience Over a Decade.
发育性髋关节脱位患儿切开复位的疗效:十年多的多中心经验。
J Pediatr Orthop. 2023 Jul 1;43(6):e405-e410. doi: 10.1097/BPO.0000000000002413. Epub 2023 Apr 10.
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Developmental Dysplasia of the Hip: Controversies in Management.发育性髋关节发育不良:治疗中的争议
Curr Rev Musculoskelet Med. 2022 Aug;15(4):272-282. doi: 10.1007/s12178-022-09761-8. Epub 2022 Apr 30.
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