挖深髋臼对髋关节发育影响的实验研究

Experimentalresearchoftheinfluencesonthedevelopementofthehipjointswithexcavatedacetabula

目前，对治疗先天性髋关节脱位的挖臼手术，尚有争论。为探讨挖除范围对髋关节发育的影响，作者将出壳饲养２个月的鸡雏６０只，分成左髋切开脱位再复位、左髋臼软骨部分挖除和左髋臼软骨全部挖除三组。全部动物均以自身右侧为对照。结果发现：局挖组（部分挖臼）关节活动尚可，粘连局限且轻微，对关节发育影响不大。而全挖组，则关节功能严重受损，臼内广泛粘连；光镜和电镜观察见髋臼表面被纤维组织替代，残留的软骨细胞或再生的软骨细胞有变异；股骨头亦发生类似变化。提示临床：治疗先天性髋脱位，全部挖除髋臼软骨是不可取的；若臼底有限局性骨性突起，局部挖除是允许的。

Therearestilargumentsabouttheoperationexcavatedacetabulatreatmentsforthecongenitaldislocationofthehip.Toinquireintotheinfluencesonthedevelopmentofthehipjointswithexcavatedacetabulasize,Wedivided60two-month-oldchickensintothreegroupswhichweregivenin-ciseddislocationandthenreductionpartlyexcavatedthecartilagesoftheacetabulaandexcavatedthemtotalytothelefthipsrespectively.Contrastingobservationofaltheexperimentalchickenswastakenontherightonesoftheirown.Thesecondgroupachievedafairfunctionofthejointmovement.Limitedandslightadhesionwasnotafectingthedevelopementofthejointsseriously.Thethirdgrouphad,onthecontrary,poorfunctionsbecauseofthecomprehensiveadhesionintheacetabula.Thesurfacesoftheacetabulawerereplacedbyfabrictisue.Theremainingorregeneratingcartlagecelsvaryobviouslyun-derthelightscopeandtheelectronicscope.Theheadsofthefemurshadchangedsimilarly.Itissuggest-edthatindealingwiththecongenitaldislocationofthehip,excavatingtheacetabolacatilageisnotad-visable.Partlyexcavatingispermitedwhenalimitedbonyprocessexistinginthebotomoftheacetab-ula.