青少年先天性髋关节脱位的治疗
刘好源,李雅丹
摘要(Abstract)：
<正> 先天性髋关节脱位(以下简称先髋)的病理改变随着年龄增加而逐渐复杂、严重,治疗也越困难。青少年先髋以高位脱位、头臼严重发育畸形和髋周软组织严重挛缩为其主要特征。治疗上存在着三大并发症即术后再脱位、股骨头无菌性坏死及关节僵硬。因此,其治疗一直是国内外矫形外科的棘手问题。本文对青少年先髋的治疗及有关问题综述如下:1 青少年先髋的主要病理解剖改变1.1.髋臼的病理改变 髋臼的发育停滞,相对地变浅、变小,盂唇缩窄内翻,臼内脂肪纤维组织填充,圆韧带增生肥厚或消失,臼横韧带相对地向中心内移,真臼脱出口形成骨嵴,以及假臼形成。1.2.髋周软组织挛缩与关节囊畸变 随着股骨头向上向后移位,关节囊被牵伸拉长、增厚,嵌夹于股骨颈与髋臼之间,由于髂腰肌的压迫,关节囊呈葫芦状或闭锁呈哑铃状。髋周肌群,韧带及其筋膜随着年龄增大而发生不同程度的挛缩或延长。一般来说凡与肢体纵轴平行的肌群均挛缩,跨越髋关节与肢体纵轴垂直的肌群被拉长。1.3.股骨近端的病理改变 股骨头高位脱位往往发育停滞。股骨头变小,畸变致头臼大小及形态不相称。颈干角增大髋外翻畸形。前倾角增大,小粗隆前移。
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作者(Author): 刘好源,李雅丹
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参考文献(References)：
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