改良Salter截骨术治疗儿童发育性髋关节脱位的临床疗效分析

Clinical effect of modified Salter osteotomy for developmental dislocation of hip in children

目的探讨改良Salter截骨术治疗儿童发育性髋关节脱位的临床疗效和价值。方法回顾分析2015年1月至2017年3月因发育性髋关节脱位在河南省人民医院住院治疗,并行改良Salter截骨术的37例患儿,采用Mckay临床功能标准及Severin影像评定标准进行术后评价。结果所有患儿行切开复位加改良Salter截骨+股骨近端截骨矫形术,手术时间:1. 8～2. 6 h,出血量:80～160 ml。术后X线:所有病例获得头臼同心复位,髋臼指数平均矫正18. 5°,术后平均随访26. 5个月(15～40个月),按照Mckay髋关节评级结果及Severin影像学评级标准优良率分别为86%和92%。结论改良Salter截骨术治疗儿童发育性髋关节脱位安全有效,可显著矫正髋臼骨性病变,改善头臼包容。

Objective To explore the clinical efficacy and advantages of modified Salter pelvic osteotomy on the treatment of DDH in children. Methods From January 2015 to March 2017,37 children with DDH were treated in our hospital with modified Salter pelvic osteotomy. The postoperative outcomes were evaluated with the Mckay＇s clinical function rating and Severin＇s imaging standard. Results All children underwent open reduction,pelvis modified Salter osteotomy and proximal femur osteotomy. The operation time was from 1. 8 to 2. 6 hours and the bleeding volume was from 80 to 160 ml. The average follow-up time was 26. 5 months（ 15 ～ 40 months）. The excellent rate of Mckay＇s hip joint rating and Severin＇s imaging rating were 86% and 92% respectively. Conclusion The modified Salter osteotomy procedure is safe and effective on the treatment of DDH in children,which can correct the pathological changes of DDH and improve the compatibility of the acetabulum to the femoral head.