梯形外展截骨术治疗儿童严重髋内翻

Ladder-shaped valgus osteotemy for severe coxa vara in children

目的 介绍一种自行设计的梯形外展截骨术治疗儿童严重髋内翻。方法 1985～ 2 0 0 0年收治 19例患儿 ,共 2 3髋采用此术式治疗。结果 19例患儿获随访 ,平均为 3年 5个月 ,畸形基本矫正 ,HE角接近正常 ,骺板线趋近水平 ,平均 8° ;颈干角平均为 12 9° ,髋关节活动自如 ,未见复发病例。结论 梯形外展截骨术是治疗儿童严重髋内翻的有效方法 ,具有操作简单、手术打击小、时间短、避免了内植入物的弊病等优点 ,符合股骨头部的生物力学规律 ,并强调了早期手术和应用HE角评价术后效果的重要性。

Objective To review the experience in correction of severe coxa vara with self-designed ladder-shaped valgus osteotemy in children.Methods Between 1985 to 2000,a new method of osteotomy was performed on 19 patients (23 hips). The average age was 6?years and 8?months. The preoperative neck-shaft angle was 60～ 100° and preoperative Hilgenereiner epiphysis angle was 60°～90° with a means 82°.Results All 19 cases were followed up for an average 3 years and 5 months. Good function was seen in all and there was no recurrence. The original vertical osteoepiphysis line was changed into an approximate horizontal one.Conclusions Ladder-shaped valgus osteotemy is efficient way for severe coxa vara, especially in children. We play emphases in early diagnosis and operation and estimation of postoperative value of HE.