大龄先天性髋脱位的术后严重并发症及其预防

Complications and Prevention of OongenitalDislocation of The Hip in Patients Over 12-Year-Old

大龄先天性髋脱位（ＣＤＨ）一般是指１２岁以上未做过治疗或保守治疗失败的病例。近年来，由于我国骨科事业的迅速发展及人民生活水平的不断提高，这类患者要求诊治者较多。可惜近远期效果均不十分理想。作者无选择地随访了我院自１９８３年５月～１９８８年５月手术治疗的２３例患者及作者在外院工作期间门诊检查外院手术治疗的患者４人，计２７个患者３２个髋，发现其术后并发症不但高而且比较严重（不包括原位加盖的３个髋）。主要有股骨头缺血性坏死２９髋（１００％）；髋关节再脱位３髋（１０．３４％）；髋关节半脱位１１髋（３７．９３％）；髋关节僵硬１７髋（５８．６２％）；髋内翻畸形１４髋（４８．２８％）；退行性髋关节炎２６髋（８９．６６％）。并发症之严重及发生率之高，令人感到吃惊。

Abstract Reoent years, a variety of operations and methodsare aveilable for the treatment of congenital dislooationof the hip in patients over 12-year-old,however , theshort and long term results are not as satisfactory asexpected. The authors followed up 23 patients who had been operated upon from May 1983 toMay 1988 and 4 patients treated in the other hospital Totally 27 patients(32 hips ) were revieved , It was found that the incidence of the complications was very high and severd; namely; the ischemic necrosis of the femoral heads occurred in 29 hips(100%)’redislooation in 3 hips(10.34%),subluxation in 11 hips(37.93%),ankylosis of the joint in 17 hips(58.62%),coxa vara in 14 hips(48,28%),arthritis in 26 hips(89.66%),The prevention of the above mentioned complications mainly depends upon appropriate choice of the surgical procedures for the individual case. Merely attempting surgical reduction of the hip joint without oonsidering proper selection of the methods will lead to failures.