股骨颈前倾角的矫正在治疗儿童DDH的价值

Application of femoral neck anteversion′s correction in the treatment of children′s developmental dysplasia of the hip

目的探讨股骨颈前倾角(FNA)的矫正在治疗儿童发育性髋关节发育不良(DDH)中的价值。方法回顾性分析2006年1月至2010年1月行手术治疗的DDH患儿98例(114髋),术前及术后进行X线及三维CT检查测量FNA,随访时间12～48个月,平均32个月。结果根据Mckay髋关节功能评分标准进行评价,优:84髋(73.68%),良:20髋(17.54%),可:10髋(8.77%),差:0髋(0%),FNA平均缩小16.3°±2.0°,术后患侧的FNA与术前比较差异有统计学意义(P<0.01);与正常侧比较,差异无统计学意义(P>0.05)。结论 FNA是儿童DDH重要的骨性病理改变之一,正确矫正是决定手术成败的关键因素之一。

Objective To discuss application of femoral neck anteversion′s correction in the treatment of children′s developmental dysplasia of the hip.Methods 98 children diagnosed DDH from Jan 2006 to Jan 2010 were treated and followed up ranging from 12 to 48 months,average 32 months.Before the operations,FNA index were evaluated by X-ray and thin slice hip joint scan and 3D reconstruction to guide the rotary osteotomy.After the operations,FNA index were rechecked.Results According to Mckay′s classification,clinical assessment was performed.84 hips were evaluated as excellent（73.68%）,20 hips as good（17.55%）,10 hips as acceptable（8.77%）,and no poor hip（0%） was reported.FNA decreased averagely 16.3°±2.0°.FNA had significant difference with themselves before the operations（P0.01） and had no significant difference with the normal side（P0.05）.Conclusion The change of FNA is one of the most important pathological changes.FNA′s correction is one of the most valuable to guarantee success operation.