全髋置换联合转子下截骨治疗Crowe Ⅳ型DDH近期疗效观察

The short-term efficacy of Crowe Ⅳ developmental dysplasia treated by total hip arthroplasty with subtrochanteric shortening osteotomy

目的探讨人工全髋关节置换联合转子下截骨治疗CroweⅣ型髋关节发育不良(DDH)的近期疗效。方法 2012年3月至2015年3月对14例患者(16髋)行股骨转子下截骨组配式假体(S-ROM)股骨柄假体全髋关节置换治疗,观察其近期疗效。结果所有患者均选用S-ROM假体,行股骨转子下横形截骨,截骨长度2.0~3.5cm。本组随访时间平均19个月,未出现脱位、血管神经损伤、深静脉血栓、感染等并发症;术前Harris评分平均42.3分,术后9个月Harris评分平均90.4分。术前肢体平均缩短6.4cm,术后平均延长4.3cm。术后X线片示臼杯及股骨柄假体位置良好。术后6个月截骨处均获得骨性愈合。结论人工全髋关节置换联合转子下截骨治疗CroweⅣ型DDH近期疗效满意。

Objective To evaluate the short-term efficacy of total hip arthroplasty combined with subcutaneous osteotomy in the treatment of Croweiv hip dysplasia （DDH）. Methods From March 2012 to March 2015,14 patients （16 hips） underwent total hip artbroplasty with femoral distraction osteotomy S-ROM femoral stem prosthesis. And we observed its recent efficacy. Results All patients underwent S-ROM prosthesis. The patients underwent transverse osteotomy of the femoral trochanter. The osteotomy length was 2.0-3.5 cm. The average follow-up time was 19 months. And no complications such as dislocation,vascular nerve inju- ry, deep vein thrombosis and infection were observed during the follow-up. The average Harris scores improved from 42.3 preopera- tively to 90. 4 postoperatively at 9 months after the operation. The average lengths of preoperative limb shortening and postoperative limb shortening were 6.4 cm and 4.3 cm respectively. The X-ray films showed no dislocation of acetabulum and femoral prosthesis. Bone healing was achieved at 6 months after osteotomy. Conclusion This method could be a good choice for Crowe Ⅳ developmen- tal dysplasia. The short-term efficacy is satisfactory.