非手术治疗先天性髋脱位并发症原因分析

目的 提高儿童先天性髋关节脱位的疗效。方法 对114例 (151个髋 )3岁以下CDH采用经皮内收肌切断、手法闭合复位、改良蛙式石膏、可调式铝合金支架治疗经2～12年随访。结果 114例闭合复位成功 ,疗效评定 :7～12个月优占89.2 % ,良占10.8 % ;13～24个月优占74 % ,良占19 % ;25个月以上优占9.5% ,良占14.2 %。发生股骨头缺血性坏死22个髋占14.6 % ,残余髋臼发育不良18个髋占11.9 %。 结论 对儿童先天性髋关节脱位采用保守疗法要注意年龄。

Objective To improve the treatment of the congenital hip dislocation in children. Methods 114 CHD patients (151 hips) below the age of three were treated by cutting of the adductor, manual reduction and frog-type cast and adjustable frame of aluminum alloy and followed up for 2 to 12 years. Results 114 cases received closed reduction. 89.2% of the treated cases had excellent therapeutic efficacy after the evaluation from 7 to 12 months. When evaluated from 13 to 24 months, the therapeutic efficacy was 74%. 9.5% of the cases had excellent therapeutic efficacy when evaluated at 25 months. 22 cases had ischemic necrosis of the hip head (14.6 %). 18 cases has residual hip development retardation (11.9 % ). Conclusion Comprehensive factors should be considered when treating the congenital hip dislocation in children with reserved therapy.