预防先天性髋脱位治疗后股骨头颈畸形的实验研究

Preventing Deformities in Femoral Head and Neck after Treating Congenital Hip Dislocation in Newborn Piglets

目的：探讨避免先天性髋脱位治疗后股骨头缺血坏死发生股骨头颈畸形的方法。方法：应用新生仔猪在其髋关节髋臼与股骨头之间嵌入间置物—同种异体膝关节半月板软骨片后分别用石膏将后肢固定于“蛙式位”和“蹲位”。定期行解剖学、组织学检查。结果：“蛙式位”固定组经过２～３个月后均出现程度不同的股骨头、颈畸形，而“蹲位”组则未发生明显的畸形。结论：在髋关节关节间置物存在的前提下，髋关节极度外展位可以使股骨头与髋臼之间的压力增加，是先天性髋脱位治疗后股骨头颈畸形发生的危险因素。“蹲位”是一种较为安全、可行的固定方法。

Objective:This study was to evaluate the techniques used to prevent femoral head necrosis and deformities following the treatment of congenital dislocation of the hip Methods: We selected new born piglets as experimental models,inserted allogenic meniscus between their acetabula and femoral heads,and then fixed the hind legs if “frog position” and “squatting position” with plaster casts. The femoral heads were harvested and examined grossly and histologically at regular intervals. Results:Femoral head and neck deformities in various degrees occurred nearly in all animals in “frog position” group after 3 months cast immobilization. No significant change was detected in “squatting position” group.Conclusion:In the presence of articular interposition, “squatting position” was much safer than “frog position” for immobilization after the reduction of congenital dislocation in hip.