Cornell M S, Hatrick N C, Boyd R, Baird G, Spencer J D
Department of Orthopaedics, Guy's Hospital, London, England.
Clin Orthop Relat Res. 1997 Jul(340):165-71. doi: 10.1097/00003086-199707000-00021.
This study reviewed 56 hips in 37 children with cerebral palsy who had undergone an adductor tenotomy alone or in combination with an anterior obturator neurectomy. The mean review period was 5.3 years. At latest review, 25 of 30 (83%) hips with a preoperative migration percentage of less than 40% were reduced, but 20 of 26 (77%) hips with a preoperative migration percentage of 40% or more were subluxated or dislocated. Surgery was unsuccessful for 13 of 15 hips with an acetabular index of more than 27 degrees. Percutaneous adductor tenotomy alone was as effective as the combination of an open procedure with an anterior obturator neurectomy. The age at the time of surgery did not have a significant effect on the outcome. The preoperative migration percentage was the only significant predictor of outcome in this group of children.
本研究回顾了37例接受内收肌切断术单独治疗或联合闭孔神经前支切除术的脑瘫患儿的56个髋关节。平均随访期为5.3年。在最近一次随访时，术前移位百分比小于40%的30个髋关节中有25个（83%）复位，但术前移位百分比为40%或更高的26个髋关节中有20个（77%）半脱位或脱位。髋臼指数大于27度的15个髋关节中有13个手术失败。单纯经皮内收肌切断术与开放手术联合闭孔神经前支切除术的效果相同。手术时的年龄对结果没有显著影响。术前移位百分比是这组儿童结果的唯一重要预测因素。
