髋臼缘截骨血管束移植治疗成人髋臼发育不良并发股骨头坏死远期随访

LONG TERM FOLLOW UP OF ACETABULAR RIM OSTEOTOMY AND ARTERY BUNDLE TRANSPLANTATION FOR THE TREATMENT OF ADULT ACETABULAR DYSPLASIA COMPLICATED WITH ISCHEMIC NECROSIS OF FEMORAL HEAD

目的探讨应用髋臼缘截骨和旋股外动脉移植在成人髋臼发育不良并发股骨头缺血性坏死的临床价值。方法对 2 0 0 8例髋臼发育不良并发股骨头缺血性坏死的病例采用骨盆髋臼缘内移截骨 ,使半脱位的股骨头产生良好的包容 ;同时对坏死的股骨头采用旋股外动脉束植入术 ,对缺血坏死的股骨头解决血液供给。结果 2 0 0 8例中 1 71 6例得到随访 ,平均随访 1 7年 6个月 ,手术优良率达 91 %。X线摄片示 :术前股骨头的覆盖率为 70 % ,术后上升到 95 % ;股骨头坏死囊性变消失率达 72 % ,使髋关节间隙比术前平均增宽 1 .5～ 4 .0mm。

ObjectiveTo investigate the clinical value of acetabular rim osteotomy and transplantation of lateral femoral circumflex artery on adult acetabular dysplasia complicated with ischemic necrosis of femoral head. Methods2 008 cases of acetabular dysplasia complicated with ischemic necrosis of femoral head were treated by ingressed osteotomy of acetabular rim in the pelvis that well covers the femoral head, at the same time, implantation of lateral femoral circumflex artery bundle used to solve the blood supply of the ischemic and necrotic femoral head. ResultsOf 2 008 cases 1 716 were followed up with an average follow up period of 17.5 years and operative excellent rate was 91.1 % . X ray films show that the coverage rate of femoral head was raised from pre operative 70 % to post operative 95 % . The disappearance rate of cystic degeneration of femoral head reached 72 % that makes the hip joint clearance broaden 1.5 ～ 4.0 mm compared with that before operation. ConclusionTreating adult acetabular dysplasia complicated with ischemic necrosis of femoral head by combining osteotomy of acetabular rim and transplantation of lateral femoral circumflex artery bundle is a good method.