Ferguson手术治疗先天性髋关节脱位

Ferguson's operation therapy in children with congenital dislocation of the hip

目的 探讨Ｆｅｒｇｕｓｏｎ 手术的手术方法和手术失败原因。方法 通过对２０ 例先天性髋关节脱位患儿共２８ 髋，用Ｆｅｒｇｕｓｏｎ 手术进行治疗并加以分析。结果 ２６ 髋复位成功，２ 髋失败。所有病儿髋关节活动均大于１３０。发生股骨头无菌性坏死者５ 髋，２ 髋出现臀肌挛缩。结论 Ｆｅｒｇｕｓｏｎ 手术不失为一种较好的早期治疗先天性髋关节脱位的方法。作者认为手术失败的主要原因是患儿治疗时年龄较大及股骨颈前倾角大于７０；其次是髋臼指数大于４０。建议术前应摄片测量股骨颈前倾角。对超过３０ 个月以上或股骨颈前倾角大于７０者或闭合复位无任何复位手感者不宜行Ｆｅｒｇｕｓｏｎ 手术。

Objective To inquire the technique of Ferguson's operation and the causes of failure in operation. Methods Ferguson's operation was performed on 28 hip joint of 20 cases(male 3, female 17) with congenital dislocation of the hip. The average age of the patients was 18.2 months (ranging from 10 to 32 months). Results Postoperatively, the hip safe zones of 26 hips were 60 ～90 , and 2 hips were 30 . The average duration of follow-up was four years and nine months (ranging from nine months to six years and seven nomths). The hip activties of the all patients exceeded 130 degree. Reduction of 26 hips succeeded. Two hips presented subluxation. Five hips presented vascular necrosis of the femoral head; tow hips bring into sight gluteus contracture. Conclusions The major cause of failure was due to the infants' age older and the femoral anteversion angles are larger. The roentgenogram must take in preoperation to measure the femoral anteversion angles. It is proposed that the infants over the age of 30 months and the femoral anteversion angles more than 70  and the closed redution without any feeling should have anterior open reduction instead of an attempt a Ferguson's operation.