Feiwell E, Sakai D, Blatt T
J Bone Joint Surg Am. 1978 Mar;60(2):169-73.
We studied seventy-six patients with myelomeningocele who were more than five years old and ahd had no hip surgery during the two previous years. Of these seventy-six patients, forty-one had had no operative treatment intended to reduce the dislocation of their hips and thirty-five had been operated on one or more times to reduce or maintain reduction of one or both hips. The presence of the femoral head in the acetabulum did not improve range of hip motion or ability to walk, nor did it reduce the amount of bracing required or decrease pain. The complications of surgical treatment to gain reduction were numerous and included failure to obtain stability in 40 per cent of the hips, loss of hip motion, and fractures. A level pelvis and a good range of hip motion were found to be more important for function than reduction of the hips. The goal of treatment should be maximum function, not roentgenographic reduction of the dislocated hip.
我们研究了76例年龄超过5岁且在过去两年内未接受过髋关节手术的脊髓脊膜膨出患者。在这76例患者中，41例未曾接受过旨在减少髋关节脱位的手术治疗，35例接受过一次或多次手术以减少或维持一侧或双侧髋关节的复位。股骨头位于髋臼内并未改善髋关节活动范围或行走能力，也未减少所需的支具使用量或减轻疼痛。为实现复位而进行的手术治疗并发症众多，包括40%的髋关节未能获得稳定性、髋关节活动丧失以及骨折。发现骨盆水平和良好的髋关节活动范围对功能而言比髋关节复位更为重要。治疗目标应是实现最大功能，而非通过X线片使脱位的髋关节复位。
