闭合复位治疗先天髋关节脱位并发股骨头缺血性坏死的分析

Avascular Necrosis of Femoral Head Following Closed Reduction in CDH

本文报告闭合复位治疗先天性髋关节脱位339例(523个髋),术后随访236例(329髋)中并发股骨头缺血性坏死47例(55个髋),发生率34％。讨论其发生的原因并提出降低股骨头缺血性坏死发生的措施。

Two hundred thirty-six(329 hips) of CDH in children under 4 year old were treated by closed reduction after various preoperative management, such as traction, adductor or/and iliopsoas tenden release, and were followed-up for one to ten years. Forty-seven(55 hips) of them were complicated by avascular necrosis of the femoral head. The incidences of avascular necrosis following the 3 diifferent Preoperative mana-gement were: 7.0%, 20.9%, and 7.1%, respectivetly. Among them, 41 were classified in typeⅠ, 12 in typeⅡ and 2 in typeⅢ. It had been considered that the main causative factors are the disturbance of the blood supply and the stress concentration on the ace-tabulum and the subchondral bone of the femoral head We concluded that the incidence could be reduced by the adoption of the preoperative management as traction and iliop-soas tenden release.