骨盆内移截骨加植骨造盖治疗大龄儿童先天性髋关节脱位

Effect of Chiari Procedure Combined with Bone Grafting and Shelf Operation Treating Congenital Dislocation of Hip Joint of Older Children

目的:研究一种大龄儿童先天性髋关节脱位的新术式,为解决大龄儿童先天性髋关节脱位、头臼不称、即股骨头大、髋臼小,用其他术式无法覆盖包容股骨头的问题.方法:骨盆内移截骨加植骨造盖及粗隆下短缩旋转截骨术治疗头臼不称的大龄儿童先天性髋关节脱位.结果:本组15例,据周永德评定标准,除有2例髋关节屈曲活动受限、1例轻度股骨头坏死外,其余均为优良,无一例半脱位及全脱位.结论:大龄先天性髋关节脱位的头臼不称、头大臼小、真假臼相连者可以推广应用骨盆内移加植骨造盖术,其优点在于单纯骨盆内移术所不能解决的真臼边缘与近端不能很好衔接的问题.

Objective：To develop an new operation technique to treat congenital dislocation of hip joint of older children to solve the problem of incompatible femoral head and acetabulum which the latter was not able to accommodate and cover the former. Methods： Congenital dislocation of hip joint of older children was treated with chiari procedure combined with bone grafting,shelf operation and subtrochanteric shortening and rotation operation. Results：The curative effect of this method was evaluated according to Zhangyongde＇s Evaluation Standard. Except for 2 cases of restricted flexion of hip joint and 1 case of slight necrosis of femoral head,the curative effect of the rest cases was excellent. Conclusion ： This technique is suitable for congenital dislocation of hip joint of older children with incompatible acetabulum and femoral head and connected true and false acetabula. It shows the advantages over chiari osteotomy of pelvis,which is able to solve the problem of margin of true acetabulum not connecting the proximal end of femur.