股骨部分大小转子截除矫形治疗严重成人髋关节发育不良

Total hip arthroplasty for developmental dysplasia of hip in the method of cutting parts of the trochanter

[目的]探讨经股骨部分大小转子截除矫形的方法,对严重髋关节发育不良患者(CroweⅣ)行全髋关节置换术后的疗效分析。[方法]对30例(32例髋)严重髋关节发育不良的患者行全髋关节置换术。其中男性3例,女性27例,患者平均年龄35.9岁(17～67岁)。假体臼杯采用金属外杯加聚乙烯内衬19例,采用骨水泥型聚乙烯臼杯固定13例。股骨柄采用Summit(Depuy,Warsaw,USA)12髋,Ribbed(LINK,Germany)12髋,S-Rom(Depuy,Warsaw,USA)8髋。股骨假体均为生物学固定,采用截除股骨部分大小转子矫形的方法。[结果]术中3例患者在假体安装中发生近端股骨骨裂,2例予以捆绑带捆扎,1例予以钢丝捆扎。1例患者术后出现患肢肿胀症状,多普勒下肢血管造影显示为深静脉血栓导致,予以保守治疗后症状消退。平均随访时间55个月(24～132个月)。术后未发现1例患者出现神经损伤症状。HHS评分由术前的37.6分提高至术后的86.3分。[结论]采取截除部分大小转子治疗髋关节发育不良的患者,手术方便,术后效果好。术中对患肢肌力无明显影响。

[ Objective ] To present the clinical and radiographic results following THA in a consecutive series of Crowe type Igpatients with developmental dysplasia of hip （DDH）, who were treated with method of cutting parts of the troehanter. [ Methods] Thirty- two hips from 30 patients 3 male, 27 female with developmental dysplasia of hip underwent total hip ar- throplasty. The average age were 35.9 years （range 17 to 67 years） . The mean follow -up period were 55 months （range 24 to 132 months） . [Results] Three proximal femur tissure fractures occurred. And two were bundled up with resorption line, one was bundled up with eirele wire. One low limb was swelling after operation due to deep vein thrombosis. The swelling low limb re- covered after expectant treatment. There was no neural injury. HHS score increased from 37.6 preoperatively to 86. 3 postopera- tively. [ Conclusion] Treating the DDH with the method of cutting parts of the troehanter is convenient for the doctor. The post- operative results are exeellent, and it dose not effect the musele strength of the affeeted limb.