改良Pemberton手术治疗小儿发育性髋关节脱位73例分析

Improved Pemberton Operation Treatment of Developmental Dislocation of the Hip:Analysis of 73 Cases

目的应用改良Pemberton手术治疗小儿发育性髋关节脱位,分析并探讨其疗效。方法对于自2000年至2010年我院收治的采用改良Pemberton手术治疗的73例90髋小儿发育性髋关节脱位的患者进行回顾分析。结果术后经3个月～10年,平均3.4年的随访,髋关节功能恢复优良者67例85髋,占91.78%。结论改良Pemberton手术在治疗小儿发育性髋关节脱位方面有其独特的优点:(1)即使髋臼轻度旋转,便能获得较大的矫形效果,且有效避免了传统Pemberton手术因所旋转的髋臼Y形软骨薄而引起呈水平状而带来的点状负重的弊端。但本手术技术较难,并可改变髋臼的上下径,使髋臼容积减小,从而导致股骨头与髋臼不匹配,髋臼需进一步塑形。(2)不用内固定,可避免二次取出内固定的小手术。

Objective To application of the modified Pemberton operation in treatment of infantile developmental dislocation of the hip,analyze and evaluate its effect.Methods For from 2000 to 2010 in our hospital were using improved Pemberton operation in treatment of 73 cases of 90 hips in children with developmental dislocation of the hip in patients were retrospectively analyzed.Results After 3 months to 10 years,mean 3.4 years of follow-up,the functional recovery of hip in 67 cases are excellent in 85 hips,accounted for 91.78%.Conclusion Summary of modified Pemberton operation in the treatment of developmental dislocation of the hip has its unique advantages：one is even mild aectabular rotation, they can obtain a large orthopedic effect,and effectively avoid the traditional Pemberton operation due to the rotation of the acetabular cartilage caused by Y shaped thin horizontal and bring the point load of malpractice.But the operation technique is more difficult,and changes of the acetabulum on size,makes acetabular volume decreases,which leads to the femoral head and acetabulum do not match,the acetabulum for further shaping.Two is not fixed,can avoid the two fixation in small operation.