带缝匠肌髂骨块造盖治疗大龄儿童先天性髋脱位

Treatment of Congenital Dislocation of Hip with Shelf Procedure of Sartorius Muscle Pedicled Ilium Bone

目的报道应用带缝匠肌髂骨块造盖治疗大龄儿童先天性髋脱位的疗效.方法 22 例中7 例采用单纯髋臼造盖术,其余均行关节囊切开复位,股骨粗隆下短缩截骨,纠正过大的股骨颈前倾角,髋臼造盖术.年龄7～13 岁,平均9.2 岁.结果术后经6个月～8年,平均5 a的随访,按Mckay临床功能评定标准,优良率为86.5%,按Severin的X线评定标准,优良率为81%.结论带缝匠肌髂骨块髋臼造盖,可稳定和维持髋臼顶部弧形截骨的位置,提高髋臼有效宽度,恢复髋臼指数及正常CE角,使髋关节获得同心圆复位.

To study the effects of shelf procedure with sartorius muscle pedicled ilium bone to treat congenital discolation oi hip. Methods 22 cases of congenital discolation of hip aged from 7 to 13 years （9.2 years on average ）,5 cases were performed simple shell procedure, the others were performed open reduction of hip joint, shortening osteotomy on femoral tuberositates, and shelf procedure. Results ： All patients were followed up 6 months -8 years （5 years on average） with excellent and good rate 86.5 % and 81% respectively according to Mckay criteria and Severin＇s radiographic criteria. Conclusion Shelf procedure with sartorius muscle pedicled ilium bone can stabilize and keep position of arch osteotomy on the upper of the acetabulum, improve the width of acetabulum, recover acetabulum index and CE angle and obtain concentric alignment.