双侧发育性髋关节脱位同期手术的评价

The evaluation of synchronous surgical therapy for bilateral developmental dislocation of hip

目的 评价双侧发育性髋关节脱位 (DDH)同期手术的效果及优点。方法 随机分为 2组 :A组 :双侧DDH者 2 1例分次手术 ;B组 :双侧DDH 2 6例行双侧同期手术。结果 随访 2年～ 6年 2个月 ,按照Muller和Seddon评分标准 ,两组间优良率差异无显著性 ,AB两组平均疗程恢复时间分别为 2年 3个月及 1年 1个月 ;平均住院费用分别为 1 35万元及 0 5 6万元。结论 双侧DDH同期手术与分次手术治疗效果基本相同 ,前者具有双下肢对称性功能恢复好、无骨盆及脊柱代偿倾斜性疼痛、住院疗程短、医疗费用低等优点 ,但手术创伤加倍 。

Objective To evaluate the advantages and effects of synchronous surgical therapy of bilateral developmental dislocation of hip (DDH). Methods The patients were divided into two groups at random. Group A: 21 cases with bilateral DDH were operated in different stages. Group B: 26 cases with bilateral DDH were operated synchronously. Results The time of follow-up was 24～74 months. According to Muller and Seddon's criteria, there was no significant difference in the excellent and good rate between the two groups. The average recovery time was 27 months in Group A and 13 in Group B. The average hospitalization cost was $13 500 in Group A and $5 600 in Group B. Conclusion The two methods provide similar effects. The synchronous surgical therapy has advantages of good lower extremities symmetry recovery without compensatory incline of pelvis and spine. The hospitalization is short and the cost is low. But the surgical trauma is doubled, so patients who can't sustain should be operated in different stages.