摘要
作者报告５０例应用组合性手术治疗成年人麻痹性髋关节脱位，平均年龄２８．７岁，其中３６岁以上者１０例，根据髋关节脱位的不同类型，应用五种不同的组合手术方法，将既往需两次以上手术完成的恢复髋关节头臼关系的骨性手术与臀肌功能重建术一期完成，缩短了一半以上的治疗周期，术后平均随访３年４个月，效果优良４６例，占９２％，有效率达１００％。
Fiftycasesofparalyticdislocationofhipinadults(PDHA)weretreatedwithcompositesurgicalprocedure.Theaverageageofthepatientswas28.7years,andtheaveragedurationoffolow-upwas3yearsand4months.Accordingtothetypeofthedislocations,fivediferentcompositeofthesurgicalprocedureswereappliedatonesettingtocorecttherelationshipbetweentheheadandtheac-etabulum,andre-establishthefunctionsoftheglutealmuscles.Inthisseries,6patientswithgradeIPDHandsomedegreesofgluteusmediusparalysiswithoutobviouscapsularlaxationunderwenttransili-aclengtheningofthepelviscombinedwithtransferofexternalobliquemuscletoreplacethegluteusmedius.Shelfprocedurewasaddedintwoofthematthesamestage.Twenty-twopatientswithacetab-ulardysplasia,capsularlaxationandnormalneck-shaftandanteversionanglesofthefemurunderwentacetabuloplastiesorshelfprocedurescombinedwithcapsularplicationandtransferofexternalobliqueoriliopsoasmuscletoreplacethegluteusmedius.Adductorreleasewasaddedinsixofthemsimultaneous-ly.Seventeenpatientswithabnormalneck-shaftandanteversionanglesofthefemurunderwentacetab-uloplastiescombinedwithcapsularplicationandsubtrochantericosteotomy,meanwhile,transferofex-ternalobliqueoriliopsoasmuscletoreplacegluteusmuscleswasaddedinnineofthem.Threepatientswithimbalanceofthepelvisunderwentequalizationprocedures,andsubtrochantericosteotomywasaddedintwoofthem.TwoelderpatientswithgluteusmediusparalysisandnearlynormalsartoriusandmusculustensorfascialataeunderwentChiariosteotomycombinedwithposteriortransferoftheanteri-orsuperioriliacspinetoreplacethegluteusmedius.Thismethodsgreatlyshortenedthetreatmentperi-odcomparedwiththeconventionalmethod,whichusualycompletethesurgicalproceduresintwoset-tings.Excelentresultsweremadein46(92%)ofthecases.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1996年第10期641-644,共4页
Chinese Journal of Orthopaedics
关键词
成年人
麻痹性
髋关节脱位
组合手术
ParalyticDislocationofthehipAdultCompositesurgicaltreatment
