冯超;万世奇;吕学敏;郭源;

• 1:北京积水潭医院小儿骨科

摘要(Abstract)：

[目的]介绍普通牵引床牵引双入路关节镜辅助治疗难复性小儿发育性髋关节脱位(DDH)的手术技术与临床效果。[方法] 2016年1月～2017年12月对5例(5髋)难复性小儿发育性髋关节脱位行关节镜辅助治疗闭合复位术。采用护皮膜绷带协助固定患儿双下肢于普通牵引床牵引,前外及外侧双入路观察操作,镜视下切除肥厚的圆韧带、清理髋臼底部纤维脂肪组织,盂唇内翻者行外2/3放射状切开、松解缩窄关节囊及髋臼横韧带。清理完毕后关节镜监视下手法复位,双髋人类位石膏外固定,术后6～8周更换二期石膏。[结果]全部5髋在关节镜松解下复位成功。所有患儿随访18～36个月。安全角由术前的(16.54±4.85)°增至术后的(65.98±6.56)°,差异有统计学意义(P<0.05);股骨头内侧化率由术前的(65.66±20.67)%增至镜下清理后的(106.45±15.55)%,差异有统计学意义(P<0.05)。髋臼角由术前的(41.66±5.27)°降至末次随访时(27.43±5.24)°,差异有统计学意义(P<0.05)。末次随访时,1例患者出现Kalamchi-MacEwen分型Ⅰ型股骨头缺血性坏死,1例残留有髋臼发育不良,其他患儿骺板内无骨桥形成,股骨头形状修复满意。[结论]普通牵引床牵引双入路关节镜辅助下髋臼清理闭合复位术是治疗难复性小儿发育性髋关节脱位安全有效的方法。

关键词(KeyWords)： 发育性髋关节脱位;小儿;牵引;关节镜术

Abstract:

Keywords:

基金项目(Foundation): 北京市科学技术委员会首都特色项目（编号：Z161100000516051）

作者(Author): 冯超;万世奇;吕学敏;郭源;

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DOI:

参考文献(References)：

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