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大龄儿童先天性髋关节脱位的治疗(作者译)

[Treatment of congenital dislocation of the hip in older children (author's transl)].

作者信息

Gekeler J

出版信息

Z Orthop Ihre Grenzgeb. 1981 Feb;119(1):92-101. doi: 10.1055/s-2008-1051429.

Abstract

In children who are older than three years the obstacles of reduction can be overcome without danger for the blood supply of the femoral head only by operative measures. It stands the test to combine open reduction with the nearly always necessary correction of the dysplastic acetabulum, the shortening of the femur and derotating osteotomy. The results definitely depend on the individual indication and the operating technique. In cases of severe dysplasia of the acetabulum the acetabuloplasty shows better results in correction and reduction of the hip joint than Salter's osteotomy. Chiari's osteotomy of the pelvis should be taken into consideration only in such special cases with residual subluxation or with an extreme flat acetabulum. The follow up of 67 congenital dislocations of the hip in children aged between three and thirteen years shows, that operative treatment of bilateral luxation is indicated in patients between three and six years of age and unilateral luxation up to the age of adolescence.

摘要

对于三岁以上的儿童,只有通过手术措施才能克服复位障碍,而不会对股骨头的血液供应造成危险。切开复位与几乎总是必要的发育不良髋臼矫正、股骨缩短和旋转截骨术相结合经得起考验。结果肯定取决于个体指征和手术技术。在髋臼严重发育不良的情况下,髋臼成形术在髋关节矫正和复位方面比索尔特截骨术效果更好。只有在存在残留半脱位或髋臼极度扁平的特殊情况下,才应考虑骨盆的恰里截骨术。对67例3至13岁儿童先天性髋关节脱位的随访表明,双侧脱位的手术治疗适用于3至6岁的患者,单侧脱位直至青春期。

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