发育性髋关节脱位手术治疗合并股骨头坏死的危险因素

Developmental Hip Dislocation Surgery for Risk Factors Associated with Femoral Head Necrosis

目的探究与分析发育性髋关节脱位手术治疗合并股骨头坏死患者的危险因素及预防措施。方法选取本院自2016年5月-2017年5月收治的发育性髋关节脱位手术治疗患者59例,对合并出现股骨头坏死的患者进行回顾性分析。结果该组患儿共59例,进行了为期8至12个月左右的随访,在术后按照Salter的标准对患者的预后进行判断,约有14例患儿合并发生了股骨头坏死的情况,发生率为18.64%(11/59)。9至11岁组相比于6至8岁、2至5岁的患儿股骨头坏死发生率较高,差异具有统计学意义(P<0.05)。Ⅲ度脱位相比于Ⅱ度脱位、Ⅰ度脱位具有较高的股骨头坏死发生率,差异具有统计学意义(P<0.05)。未行牵引的相比于皮肤牵引、骨骼牵引的患儿具有更高的股骨头坏死发生率,差异具有统计学意义(P<0.05)。结论手术治疗发育性髋关节脱位手术虽然能够获得一定疗效,但并不能避免股骨头坏死的发生,而股骨头坏死的发生通常可收到多种因素的影响,包括了手术介入操作、患者年龄以及股骨头脱位程度等。

Objective To explore and analyze the risk factors and preventive measures of patients with developmental femoral head necrosis treated with developmental dislocation of the hip. Methods Fifty-nine patients with developmental dislocation of the hip treated in our hospital from May 2016 to May 2017 were selected for retrospective analysis of patients with femoral head necrosis. Results A total of 59 children in this group were followed up for 8 to 12 months. According to Salter's criteria, the prognosis of the patients was judged after operation. About 14 children had femoral head necrosis, the incidence was 18.64%(11/59). The incidence of femoral head necrosis in 9-11 year-old group was higher than that in 6-8 yearold and 2-5 year-old children (P < 0.05). The incidence of femoral head necrosis was higher in degree Ⅲ dislocation than in degree Ⅱ dislocation and degree Ⅰ dislocation (P < 0.05). The incidence of femoral head necrosis in children without traction was higher than those with skin traction and skeletal traction (P < 0.05). Conclusion Surgical treatment of developmental dislocation of the hip can achieve a certain effect, but can not avoid the occurrence of femoral head necrosis, and the occurrence of femoral head necrosis can usually be affected by a variety of factors, including surgical intervention, patient age And the degree of dislocation of the femoral head.