转子下外展截骨治疗先天性髋内翻长期疗效观察

Long-term folllow-up of coax vara after valaus subtrochanteric osteotomy

[目的]分析股骨转子下外展截骨治疗先天性髋内翻的长期疗效。[方法]对17例(21髋)先天性髋内翻行股骨转子下外展截骨术,术后平均随访13.6a。[结果]所有股骨头骺板早期闭合,平均10.6(5～13)岁;股骨颈部三角骨块于术后5(3～10)个月闭合;14髋股骨大转子过度增长,所有患者均有不同程度股骨颈短缩;1例术后6a发生膝外翻。[结论]手术促进股骨近端骺板和三角骨块早期闭合,稳定髋关节,但引发髋关节周围形态的畸形。截骨同时行股骨大转子骺阻滞是防止股骨大转子过度增长的方法之一。

[ Objective] To evaluate the long-term results of valgus subtrochanteric osteotomy for congenital coax vara. [ Method] Valgus subtrochanteric osteotomies were carried out on 21 congenital coax vara hips （ 17 patients）. The average du- ration of follow-up was 13.6 years. [ Result] Premature closure in the proximal femoral epiphysis was found in all patients, the average age at proximal physeal closure was 10. 6 years （5 - 13 years）. The average healing time of the triangular juxtaphyseal osseous fragment was 5 months （3 - 10 months） after osteotomy. Fourteen hips had greater trochanteric overgrowth. Short femoral necks of different degrees were found in all patients. A genu valgum was found in 1 case after 6 years from osteotomy. [ Conclusion ] The valgus subtrochanteric osteotomy can accelerate premature closure of the proximal femoral epiphysis and triangular fragment. It may lead to various deformities around hip as well as stabilize the hip joint. Greater trochanteric apophyseodesis in osteotomy procedure is one of the methods to prevent greater trochanteric overgrowth.