Salter截骨术治疗发育性髋关节脱位的临床效果

Clinical effect of Salter osteotomy on developmental dislocation of the hip

目的探讨Salter截骨术治疗发育性髋关节脱位(DDH)的临床效果。方法 200例DDH患儿按Tonnis股骨头脱位程度分为Ⅰ度组45例、Ⅱ度组60例、Ⅲ度组64例及Ⅳ度组31例,均行Salter截骨术治疗,采用Mc Kay功能评级标准与Severin影像学评级标准分别评估患者髋关节功能与影像学结果。结果术后3年患儿Mc Kay髋关节功能优良率达77.50%(155/200),其中Ⅰ度组优良率均高于Ⅱ度、Ⅲ度及Ⅳ度组(均P<0.05),Ⅱ度组优良率均高于Ⅲ度、Ⅳ度组(P<0.05),Ⅲ度与Ⅳ度组优良率比较,差异无统计学意义(P>0.05)。4组患儿术后3年Severin分级评价均优于术前(P<0.05)。结论 Salter截骨术治疗小儿DDH可获较好疗效,尤其是TonnisⅠ度、Ⅱ度患儿术后髋关节功能恢复更佳。

Objective To investigate the clinical effect of Salter osteotomy on developmental dislocation of the hip(DDH).Methods Two hundred DDH children treated with Salter osteotomy were divided into degreeⅠgroup(n=45),degreeⅡgroup(n=60),degreeⅢgroup(n=64)and degreeⅣgroup(n=31)according to Tonnis classification of femoral dislocation.McKay classification and Severin classification were respectively used to assess hip function and imaging results of the patients.Results After three years of operation,the good rate of McKay hip function was 77.50%(155/200),the rate of the degreeⅠgroup was higher than that of the degreeⅡgroup,the degreeⅢgroup or the degreeⅣgroup(all P<0.05),the rate of the degreeⅡgroup was higher than that of the degreeⅢgroup or the degreeⅣgroup(P<0.05),and no significant difference was found in the good rate between the degreeⅢgroup and the degreeⅣgroup(P>0.05).The postoperative 3-year Severin grade was superior to the preoperative among the four groups(P<0.05).Conclusion Salter osteotomy has better efficacy for children with DDH,especially for children with Tonnis degree I and II,achieving better hip function recovery after operation.