秦宏敏;殷光义;赵良虎;邹拥军;邢学红;张帆;刘洪全;黄金;甘华刚;杨勇;

• 1:四川省攀枝花学院附属医院骨科医院

摘要(Abstract)：

[目的]评价非截骨全髋关节置换术(total hip arthroplasty THA)在CroweⅢ、Ⅳ型成人髋关节发育不良(developmental dysplasia of the hip in adults,DDH)患者中的疗效。[方法]对2007年2月～2012年4月在本院采用非截骨THA治疗CroweⅢ、Ⅳ型成人DDH患者26例(29髋)的病人进行手术疗效分析,术前术后肢体长度测量、Harris髋关节功能评分及术后随访。[结果]截至随访终点,共24例(26髋)获得随访,随访0.5～4.5年,平均24个月。术前双侧肢体长度差别为0.5～4.0 cm(平均3.2 cm),术后双侧肢体长度差别为0～1.0 cm(平均0.35 cm)。术前Harris评分平均为41分(35～79)分,术后Harris评分平均为90分(78～96)分。[结论]通过松解延长、采用合适的人工关节假体使用非截骨THA治疗CroweⅢ、Ⅳ型成人DDH患者的手术效果稳定,手术技术具有可重复性,能够获得满意的疗效。

关键词(KeyWords)： 非截骨THA;成人DDH;髋关节;功能

Abstract:

Keywords:

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作者(Author): 秦宏敏;殷光义;赵良虎;邹拥军;邢学红;张帆;刘洪全;黄金;甘华刚;杨勇;

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参考文献(References)：

• [1]Colton CL.Chiari osteotomy for acetabular dysplasia in young sub-jects[J].J Bone Joint Surg Br,1972,4:578-589.
• [2]Rejholec M.Combined pelvic osteotomy for the bipartite acetabulumin late developmental dysplasia of the hip:a ten-year prospectivestudy[J].J Bone Joint Surg Br,2011,2:257-261.
• [3]Tokunaga K,Aslam N,Zdero R,et al.Effect of prior Salter orChiari osteotomy on THA with developmental hip dysplasia[J].ClinOrthop,2011,1:237-243.
• [4]Harris WH,Crothers O,Oh I.Total hip replacement and femoralhead bone-grafting for severe acetabular deficiency in adults[J].JBone Joint Surg Am,1977,59:752-759.
• [5]Gerber SD,Harris WH.Femoral head autografting to augment ace-tabular deficiency in patients requiring total hip replacement.Aminimum five-year and an average seven-year follow-up study[J].J Bone Joint Surg Am,1986,68:1241-1248.
• [6]Boyle MJ,Frampton CM,Crawford HA.Early results of total hiparthroplasty in patients with developmental dysplasia of the hip com-pared with patients with osteoarthritis[J].J Arthroplasty,2012,6:1003-1007.
• [7]Roberts CS,Fetto JF.Functional outcome of hip fusion in the youngpatient.Follow-up study of 10 patients[J].J Arthroplasty,1990,1:89-96.
• [8]Cuckler JM.Dealing with post-traumatic arthrosis of the hip[J].Orthopedics,2001,9:867-878.
• [9]Bruce WJ,Rizkallah SM,Kwon YM,et al.A new technique ofsubtrochanteric shortening in total hip arthroplasty:surgical tech-nique and results of 9 cases[J].J Arthroplasty,2000,5:617-626.
• [10]刘瑞宇,王坤正,王春生,等.不同程度髋关节发育不良继发骨性关节炎的全髋关节置换术疗效分析[J].中国矫形外科杂志,2008,21:1613-1615.
• [11]张涛,郭源.Pemberton截骨术治疗大龄儿童髋关节发育不良的疗效分析[J].中国矫形外科杂志,2008,17:1281-1284.
• [12]毛宾尧,胡裕桐,司全明,等.植骨髋臼成形的人工全髋关节置换治疗髋关节发育不良[J].中国矫形外科杂志,2004,19:1445-1449.
• [13]Krych AJ,Howard JL,Trousdale RT,et al.Total hip arthroplastywith shortening subtrochanteric osteotomy in Crowe type-IV devel-opmental dysplasia[J].J Bone Joint Surg Am,2009,9:2213-2221.
• [14]韩铭,王式鲁,董建文,等.全髋关节置换术治疗先天性髋关节发育不良[J].中国矫形外科杂志,2005,3:193-194.
• [15]史立伟,赵群,张立军,等.发育性髋关节发育不良与关节松弛的相关性研究[J].中国矫形外科杂志,2009,13:973-976.
• [16]Reikeras O,Haaland JE,Lereim P.Femoral shortening in total hiparthroplasty for high developmental dysplasia of the hip[J].ClinOrthop,2010,7:1949-1955.
• [17]Türker M,Crpar M,Cetik O,et al.Comparison of two techniquesin achieving planned correction angles in femoral subtrochantericderotation osteotomy[J].J Pediatr Orthop B,2012,3:215-219.
• [18]Starker M,Bischof F,Lindenfeld T.Total hip arthroplasty withshortening subtrochanteric osteotomy and custom-made prosthesisin Crowe type IV developmental dysplasia[J].Z Orthop Unfall,2011,5:518-525.
• [19]郝鹏,裴福兴,沈彬,等.全髋关节表面置换治疗成人先天性髋关节发育不良与近期疗效[J].中国矫形外科杂志,2006,23:1787-1791.
• [20]Kindsfater KA,Politi JR,Dennis DA,et al.The incidence of femo-ral component version change in primary THA using the S-ROMfemoral component[J].Orthopedics,2011,4:869-873.
• [21]Mattingly DA.The S-ROM modular femoral stem in dysplasia ofthe hip[J].Orthopedics,2005,9:1069-1073.
• [22]赵建宁,郭亭,周利武,等.全髋关节表面置换术治疗成人髋关节发育不良中假体的安放技术和临床疗效分析[J].中华关节外科杂志,2008,4:374-378.
• [23]赵云鹤,朱延兵,谭云冰,等.人工全髋关节置换术治疗发育性髋关节发育不良[J].中国矫形外科杂志,2004,14:1066-1068.
• [24]Chung CY,Lee KM,Park MS,et al.Validity and reliability ofmeasuring femoral anteversion and neck-shaft angle in patientswith cerebral palsy[J].J Bone Joint Surg Am,2010,5:1195-1205.
• [25]Dandachli W,Kannan V,Richards R,et al.Analysis of cover of thefemoral head in normal and dysplastic hips:new CT-based tech-nique[J].J Bone Joint Surg Br,2008,11:1428-1434.
• [26]毛宾尧,黄涛.髋关节发育不良的全髋关节置换[J].中国矫形外科杂志,2007,3:193-196.
• [27]沈彬,裴福兴,杨静.髋关节发育不良的髋臼重建[J].中华外科杂志,2004,16:1001-1005.
• [28]Kraay MJ,Moore RD,Martell JM,et al.Reassessment of comput-erized wear measurement for total hip arthroplasty with correction forprojectional image distortion:a brief follow-up report[J].J BoneJoint Surg Am,2010,9:1858-1867.