摘要
通过对先天性髋脱位髋关节造影的影像研究,发现导致闭合复位失败的原因。作者对36例,40髋3周岁以下先天性髋脱位患儿行髋关节造影,皮牵引3周后常规闭合复位,其中25髋成功,15髋失败。分别对其术前造影进行比较分析。发现复位失败组的驼峰样盂唇及髂腰肌切迹的发生率明显高于闭合复位成功组。而由二者形成的关节囊狭窄及囊径与头径的比例不适是构成复位失败的主要原因。对两组的囊径与头径比值行统计处理发现,闭合复位成功组为:0.74±0.16;而复位失败组为:0.38±0.09,P值<0.01。臼径与头径比值无显著差异。导致关节囊狭窄的主要原因是肥大的盂唇及挛缩之髂腰肌所致。在复位前进行关节造影,能有效的预估婴幼儿先天性髋脱位闭合复位的成功与否。
Arthrographywasdonein40hipsof36patientsunder3yearsofage,withcongenitaldislocationofhip(CDH).Closedreductionwasdoneafter3weeksofskintraction.25hipshadsuc-cessfulreductionand15failed.Analysisofthepre-reductionarthrogramshowedthatinthefailedgrouptheratioofthehump-likelimbusandtheincisuraofiliopsoasmusclewashigherthanthatinthesuc-ceededgroupandthattherewasextensivestenosisofthejointcapsulewhichledtotheabnormalratiobetweenthecapsuleofthehipandthefemoralhead.Theaforementionedfactsseemedtobethemaincausesoffailure.Thediametricratiobetweenthecapsuleofthehipandthefemoralheadwasstudiedstatisticaly.Thefigureswere0.74±0.16VS0.38±0.09respectivelyinthesucceededandthefailedgroups(P<0.01).Theratiobetweentheacetabularandthefemoralheadshowednosignificantdifer-ence.Stenosisofthejointcapsuleiscausedbytheenlargedacetabularlabrumandthecontractediliop-soasmuscle.Pre-reductionarthrographyenablesthesurgeontoestimateaccuratelythesuccessofcosedreductionmanoeuvreforCDH.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1996年第10期636-637,共2页
Chinese Journal of Orthopaedics