“学步期”儿童发育性髋关节脱位手术治疗的可行性研究

The Study on Feasibility for Developmental Dislocation of the Hip on "walking age" with Surgical Treatment

目的探讨手术治疗"学步期"儿童发育性髋关节脱位(developmental dislocation of the hip,DDH)的临床可行性。方法选择本院12～18个月发育性髋关节脱位患儿56例(均为Tonnis分级Ⅲ、Ⅳ度)。患儿中采取切开复位Salter骨盆截骨术者为实验组,共36例;采用传统手法复位蛙式位石膏外固定(复位困难采取内收肌群切断术)患儿对照组,共20例。结果随访14～60个月,实验组优良率92.31%,对照组优良率83.33%,2种治疗方法对比有明显的统计学意义(P<0.05)。且对照组在后期随访中出现2例再脱位,2例股骨头坏死,而实验组无一例出现。结论采取手术治疗"学步期"儿童发育性髋关节脱位可以更准确还原髋臼和股骨头的同心圆关系,而且固定可靠不宜再脱位,更有助于髋关节向正常方向发育,具有临床可行性。

Objectives To investigate the clinical feasibility of Developmental Dislocation of the Hip （DDH） on ＂walking age＂ with surgical treatment.Methods 56 cases of children having DDH between 12and 18 ages with Tonnis grading Ⅲ、Ⅳwhich is divided to two groups calling the experimental group and the control group.The experimental group were treated with open reduction and Salter innominate osteotomy, the control group were treated with manipulative reduction and frog leg position plaster fixation.Results With 12 to 60 months follow-up, the experimental group and the control group are excellent in good rate of 94.64% and 91.85%, both methods have obviously statistical significance（P0.05）.And the control group have 2 cases with redislocation and 2cases leading to perthes, the experimental group doesn’t happen.Conclusion Surgical treatment to DDH on ＂walking age＂ can help to maintain concentric circles between the acetabulum and the femoral head, is difficult to redislocation, is good for hip joint to normal development, which has the clinic feasibility.