小儿发育性髋关节脱位的关节镜下治疗

Arthroscopic treatment of developmental dislocation of the hips in infants

[目的]探讨关节镜在小儿发育性髋关节脱位（DDH）治疗中的应用价值。[方法]所有患儿经理学检查、X线及螺旋CT诊断为DDH,并一部分为闭合复位再脱位,另一部分为难复位。将所有病人随机分两组：一组经关节镜治疗,21例,男7例,女14例,左侧14髋,右侧12髋,共26髋;年龄6～30个月,平均17.4个月。另一组为对照组,经Ferguson手术,25例,男8例,女17例,左侧16髋,右侧13髋,共29髋;年龄8～32个月,平均18.9个月。两组均清除妨碍复位的因素并使关节成形,复位石膏外固定10个月。[结果]按周永德评分标准,关节镜治疗组：优10髋,良11髋,中3髋,差2髋。Ferguson手术组：优11髋,良10髋,中7髋,差1髋。两组间各级比较,统计学无显著性差异（P〉0.05）。[结论]关节镜在直视下观察并清除妨碍股骨头复位的因素,成形关节。此项技术,在一定条件下是可采纳的微创治疗DDH方法。

[ Objective] To evaluate the effect of arthrocopy on the treatment of developmental dislocation of the hips （DDH） in infants. [ Method] All the infants were diagnosed as having developmental dislocation of hip by physical examination, X - ray and CT. Some of them had redislocation after closed reduction, and others had refractory closed reduction. Patients were randomly classified into two groups. Group A underwent arthrocopic treatment. It included 21 infants with the ages of 6 - 30 months （ M =7, F = 14 ; 14 left and 12 right hips） . Group B underwent Ferguson treatment. It included 25 infants with the ages of 8 -32 months （M =8, F =17; 16 left and 13 right hips ） . The factors affecting hip reduction were removed thoroughly, and the hips were given a external fixation with plaster for 10 months. [ Result ] According to ZHOU Yong - de criterion, in group A, 10 cases were exellent, 11 good, 3 fair, 2 poor, and in group B, 11 cases were exellent, 10 good, 7 fair, 1 poor. There was no significant difference between 2 groups （P 〉 0. 05） . [ Conclusion] The factors causing reductions should be removed arthroscopically. Arthrocopy may be a useful micro -treatment method for DDH.