不同股骨截骨方式对发育性髋关节发育不良全髋关节置换术并发症及髋关节功能的影响

The Effects of Different Femoral Osteotomy Methods on the Complications and Hip Joint Function of Total Hip Replacement for Developmental Dysplasia of the Hip

【目的】探讨不同股骨截骨方式对发育性髋关节发育不良(DDH)全髋关节置换术(THR)并发症及髋关节功能的影响。【方法】选取2021年1年至2022年10月在本院行THR治疗的95例DDH患者,按不同股骨截骨方式分为A组[采用转子下短缩截骨(SSO)方式,n=32]、B组[采用转子延长截骨(ETO)方式,n=32]、C组(采用大转子长斜形截骨方式,n=31),比较三组手术相关指标、髋关节功能评分及并发症发生情况。【结果】C组手术时间短于A组、B组,总出血量少于A组、B组,差异均有统计学意义(P<0.05)。术后1周、术后1个月、术后3个月,C组髋关节功能评分均高于A组、B组(P<0.05)。C组截骨处愈合时间、术后1年下肢长度差少于A组、B组(P<0.05);术后1周,C组疼痛程度均低于A组、B组(P<0.05)。三组并发症发生率比较,差异无统计学意义(P>0.05)。【结论】DDH患者采用不同股骨截骨方式行THR治疗均能有效改善患者髋关节功能,降低并发症发生率,但采用大转子长斜形截骨方式可明显缩短手术时间,减少总出血量,促进患者康复。

【Objective】To investigate the effects of different femoral osteotomy methods on the complications and hip joint function of total hip replacement(THR)for developmental dysplasia of the hip(DDH).【Methods】A total of 95 DDH patients who underwent THR treatment in our hospital from January 2021 to October 2022 were selected and divided into three groups according to different osteotomy methods:Group A[using short and shortened trochanter osteotomy(SSO),n=32],Group B[using extended trochanter osteotomy(ETO),n=32],and Group C(using large trochanter long oblique osteotomy,n=31).The surgical related indicators,hip joint function scores,and incidence of complications were compared among the three groups.【Results】The results showed that the operation time of Group C was shorter than that of Group A and Group B,and the total bleeding volume was less than that of Group A and Group B,with statistically significant differences(P<0.05).At 1 week,1 month,and 3 months after surgery,the hip joint function scores of Group C were higher than those of Group A and Group B(P<0.05).The healing time of the osteotomy site and the difference in lower limb length one year after surgery in Group C were less than those in Group A and Group B(P<0.05);One week after surgery,the pain level in Group C was lower than that in Group A and Group B(P<0.05).There was no statistically significant difference in the incidence of complications among the three groups(P>0.05).【Conclusion】The use of different femoral osteotomy methods for THR treatment in DDH patients can effectively improve hip joint function and reduce the incidence of complications.However,the use of a large trochanter long oblique osteotomy method can significantly shorten the surgical time,reduce total bleeding,and promote patient recovery.