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先天性髋关节脱位的治疗进展(作者译)

[Development in the treatment of congenital dislocation of hip (author's transl)].

作者信息

Vizkelety T, Rényi-Vámos A

出版信息

Magy Traumatol Orthop Helyreallito Seb. 1979;22(3-4):286-98.

PMID:43435
Abstract

Authors review the development in the treatment of congenital dislocation and dysplasy of hip and demonstrate the results with various methods. Results with treatment according to Lorenz (1040 cases) were unsatisfactory because of frequent occurance (66.3 percent) of osteochondritis. The treatment with Frejka cushion (360 cases) did not improve basically the results. Pavlik's strapping, especially when started under 1 month of age gave excellent results (3156 cases). In operative treated the results of 332 Colonna operations were unsatisfactory because of consecutive deformation of the hip and restriction of movements. Open reduction with varisation derotation osteotomy (474 cases) provided good acetabular development especially in cases where articular cartilage and upper limbus could be saved. Salter's operation is successful when proper indications are considered, but should be performed only after 1--2 years of observation of the acetabular development in non improving cases. The Chiari procedure can improve the weight bearing surfaces in cases of steep acetabular roof flat acetabulum and consecutive subluxation. In 557 cases of varisation derotation osteotomy subcapital coxa valga occured frequently. Basic principle of treatment remains prevention, early recognition and treatment after birth.

摘要

作者回顾了先天性髋关节脱位和发育不良的治疗进展,并展示了各种治疗方法的结果。根据洛伦兹方法治疗的结果(1040例)并不理想,因为骨软骨炎的发生率较高(66.3%)。使用弗雷伊卡臀枕治疗(360例)基本没有改善治疗效果。帕夫利克吊带法,尤其是在1个月龄以下开始使用时,取得了优异的治疗效果(3156例)。在手术治疗方面,332例科隆纳手术的结果并不理想,因为髋关节出现了连续性变形和活动受限。内翻旋转截骨术的切开复位(474例)尤其在关节软骨和上缘得以保留的情况下,能使髋臼发育良好。考虑到适当的适应症时,索尔特手术是成功的,但仅应在对髋臼发育无改善的病例观察1至2年后进行。对于髋臼顶陡峭、髋臼扁平及连续性半脱位的病例,恰里手术可改善负重面。在557例内翻旋转截骨术中,股骨头下髋外翻经常发生。治疗的基本原则仍然是预防、早期识别和出生后治疗。

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