小儿先天性髋关节脱位闭合复位并发症的原因分析

AN ANALYSIS ON CAUSES FOR COMPLICATIONS FOLLOWING CLOSED REDUCTIONOF CONGENITAL DISLOCATION OF THE HIP IN YOUNG CHILDREN

为探讨闭合复位治疗儿童先天性髋关节脱位并发症的发生原因，提高复位成功率。对采用闭合复位后蛙式石膏和蛙式支架分期固定治疗的２８４例（３９８髋）先天性髋关节脱位，进行了１．５～６年的临床随访，并对５８髋出现并发症的原因进行了分析。结果显示，５８髋中３２髋发生股骨头缺血性坏死，２４例发生再脱位（或半脱位），２例出现股骨颈骨骺滑脱，复位优良率为８６％。认为，儿童先天性髋关节脱位闭合复位所出现的并发症，主要与髋关节本身的病理情况、患儿年龄、复位后固定的位置、复位技能等因素有关。强调在行闭合复位时，应严格掌握其适应症。对于出现并发症者，则应尽早治疗。

おn order to study the causes for complications following closed reduction of congenital dislocation of the hip (CDH) in children and improve the successful rate of closed reduction, 284 cases (398 hips) treated by staged plaster and brace fixation in a frog possition were followed up for 1.5-6 years, and the causes were analysed for the complications occurring in 58 hips. The results showed 32 hips were complicated with ischemic necrosis of femoral head, 24 with recurrent dislocation or subluxation, and 2 with slipped epiphysis of femoral neck, and the excellentgood rate of the reduction reached 86 %. The authors believed that the complications of closed CDH reduction may be related to the pathological change of the hip, patients age, possition of external fixation after reduction, orthopedists skills for reduction, and so on. The indications of closed reduction should be strictly selected, and the complications that have occurred should be prevented and treated as early as possible.