Westin G W, Dallas T G, Watanabe B M, Ilfeld F W
Isr J Med Sci. 1980 Apr;16(4):318-22.
A review of skeletal traction compared with femoral shortening in treatment of older patients with congenital dislocation of the hip clearly favors femoral shortening. During the period 1952-74, 30 hips in 22 patients (average age, 6 6/12 years) were treated with skeletal traction, and during 1971-77, 17 hips in 12 patients (average age, 6 8/12 years) were treated with femoral shortening. In those treated with skeletal traction, avascular necrosis developed in 57%; redislocation or subluxation in 30%; an X-ray rating (Severin) of poor in 43%; and the incidence of pin and skin complications was 27%. The average follow-up was 11 1/2 years. In the group treated with femoral shortening, there were no cases of avascular necrosis and none with a poor rating on X-ray. The average follow-up was three years and seven months and it was never less than one year. Complications included one refracture at the osteotomy site six weeks after surgery, one late resubluxation, and two redislocations (early in the series prior to routine use of Steinmann pin fixation). The redislocations were easily reduced. Acceptable leg length inequality was present in all unilateral cases except in one 12-year-old patient who required a contralateral epiphysiodesis. One patient with late subluxation had open reduction and acetabuloplasty.
一项关于骨骼牵引与股骨缩短术治疗老年先天性髋关节脱位患者的综述明确显示，股骨缩短术更具优势。在1952年至1974年期间，22例患者（平均年龄6又6/12岁）的30个髋关节接受了骨骼牵引治疗；在1971年至1977年期间，12例患者（平均年龄6又8/12岁）的17个髋关节接受了股骨缩短术治疗。接受骨骼牵引治疗的患者中，57%发生了缺血性坏死；30%出现了再脱位或半脱位；43%的X线评级（塞韦林）较差；针道和皮肤并发症的发生率为27%。平均随访时间为11又1/2年。在接受股骨缩短术治疗的组中，没有缺血性坏死病例，X线评级也没有较差的情况。平均随访时间为3年7个月，且从未少于1年。并发症包括术后6周在截骨部位发生1例再骨折、1例晚期再半脱位和2例再脱位（在该系列早期，常规使用斯氏针固定之前）。这些再脱位很容易复位。除1例12岁患者需要对侧骨骺阻滞术外，所有单侧病例均存在可接受的下肢长度不等。1例晚期半脱位患者接受了切开复位和髋臼成形术。
