Salter截骨术与Pemberton截骨术治疗儿童期发育性髋关节脱位疗效比较

Comparison of Salter osteotomy and Pemberton osteotomy in treatment of developmental dislocation of hip in children

目的:比较Salter截骨术与Pemberton截骨术治疗儿童期发育性髋关节脱位的效果。方法:收集2009年6月至2013年1月安徽医科大学附属省儿童医院收治的儿童期发育性髋关节脱位患儿100例,根据所采取的截骨术不同分为Salter组(n=63)与Pemberton组(n=37)。观察比较2组患儿的股骨头坏死率和预后转归情况。结果:Salter组与Pemberton组治疗优良率比较,差异无统计学意义(P>0.05);末次随访时Pemberton组患儿的骨性髋臼指数改善更为显著(P<0.001),而CE角和Reimers不稳定指数的改善情况,2组间差异无统计学意义(P>0.05);Salter组患儿的股骨头坏死率明显低于Pemberton组(P=0.041)。结论:Salter截骨术与Pemberton截骨术均是治疗儿童期发育性髋关节脱位的有效方法,但Salter截骨术可以明显降低股骨头坏死率,有效改善患儿的预后。

Aim：To investigate the effect of Salter osteotomy and Pemberton osteotomy on developing hip dislocation in children. Methods：A total of 100 children with childhood developmental hip dislocation who were admitted to the Affiliated Provincial Children＇s Hospital of Anhui Medical University from June 2009 to January 2013 were collected. According to the osteotomy used,they were allocated into Salter group（ n = 63） and Pemberton group（ n = 37）. The femoral head necrosis rate and prognosis outcomes were compared between the two groups. Results：There was no significant difference in the response rate of treatment between the Salter group and the Pemberton group（ P〈0. 05）. At the last follow-up,the bone acetabular index improved more significantly in the Pemberton group（ P 0. 001）,while the improvement in the CE and Reimers instability index was not significant（ P〈0. 05）. The rate of femoral head necrosis in the Salter group was significantly lower than that in the Pemberton group（ P = 0. 041）. Conclusion：Both salter osteotomy and Pemberton osteotomy are effective methods for treating developmental dislocation of the hip in childhood. However,compared with Pemberton osteotomy,Salter osteotomy could significantly reduce the rate of femoral head necrosis and effectively improve the prognosis of children.