先天性髋关节脱位髋臼覆盖重建术式的选择

Selection of the Methods for Reconstruction of Dysplastic Acetabulum in Congenital Dislocation of the Hips

自１９９４年１２月，我科对３８例５２髋先天性髋关节脱位术前不牵引，一期综合手术矫正全部畸形。手术中依据股骨头与髋臼的病理改变，本组５２髋中，３４髋行Ｓａｌｔｅｒ骨盆截骨，１５髋行髋臼加盖，３髋行Ｐｅｍｂｅｒｔｏｎ截骨。本组５２髋术后均获得满意复位，髋臼覆盖明显改善。其中３０例４１髋随访８～３０个月，按Ｍｕｌｅｒ和Ｓｅｄｄｏｎ的标准，优２８髋，良１０髋，可３髋。由于每例先天性髋关节脱位的病理改变有所不同，对其髋臼覆盖重建方式应根据具体情况灵活选择。

From December, 1994, 38 patients, 52 hips underwent one-stage procedures without preoperative traction, which corrected all the deformities at the same time. Based on the pathological changes of femoral heads and acetabulum, Salter innominate osteotomy was performed in 34 hips, modified shelf operation in 15 hips and Pemberton pericapsular osteotomy in 3 hips. Satisfactory reduction was archived in all of the 52 hips, and the acetabular coverage was significantly improved after the operation. Of the 38 patients, 30 cases, 41 hips were followed up from 8 to 30 months. According to the assessment of Muller and Seddon, excellent results were got in 28 hips, good in 10 hips, fair in one hip. Because the pathological changes are different in each patient, the measure of reconstruction of dysplastic acetabulum should be selected according to the essential condition.