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[目的]对经典Salter截骨术和改良Salter截骨术治疗先天性髋关节发育不良的疗效进行比较。[方法]将先天性髋关节发育不良的89例107髋患儿,根据术式不同分成两组:(1)经典Salter手术组47例56髋。严格按Salter手术进行操作,术后贝氏石膏固定。(2)改良Salter手术组42例51髋。截骨时用骨刀在髂前上下棘之间从前向后截断仅保留坐骨大切迹的少许皮质。用同种异体骨植入在截骨处,不用细克氏针固定,同时在股骨粗隆下旋转截骨,钢板内固定,术后髋人字石膏固定。[结果]本组病例随访76例,随访时间1～9年,平均5年。参照1994年全国小儿髋关节疾病专题研讨会修订的先天性髋关节脱位疗效评价标准,经典Salter手术优良率为78.0%,平均总评分22.80分,为良。改良Salter手术组优良率为96.4%,平均总评分28.74分,为优。[结论]改良Salter手术组治疗先天性髋关节发育不良,疗效明显优于经典Salter手术组,而且改良Salter手术组术后并发症少,外形及术后功能均好。
[Objective] To compare the curative effect of classic Salter osteotomy and modified Salter osteotomy for the treatment of congenital hip dysplasia. [Methods] 89 cases of congenital dysplasia of hip in 107 children with hip were divided into two groups according to different surgical procedures: (1) 47 cases of 56 hips in the classic Salter operation group. Strict operation by Salter operation, postoperative Bethel cast immobilization. (2) Forty-one hips of 42 patients with Salter operation were modified. Osteotomy with a bone knife in the anterior superior iliac spine between the anterior and posterior cut only retain the large sciatic notch a little cortex. With allogeneic bone implants at the osteotomy, without fine Kirschner wire fixation, at the same time in the femoral tuberosity rotation osteotomy, plate fixation, postoperative hip gypsum fixation. [Results] 76 patients were followed up for 1 to 9 years with an average of 5 years. With reference to the evaluation standard of curative effect of congenital dislocation of the hip which was revised in 1994 National Symposium on Hip Joint Disease, the excellent and good rate of classic Salter operation was 78.0% and the average total score was 22.80, which was good. The improved Salter operation group was 96.4% excellent and good, with an average total score of 28.74 points. [Conclusion] The modified Salter operation group is superior to the classic Salter operation group in the treatment of congenital dysplasia of hip, and the postoperative complications of modified Salter operation group are less, and the appearance and postoperative function are good.