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目的探讨Salter髂骨截骨联合股骨粗隆下截骨术治疗小儿发育性髋关节脱位的疗效,分析其手术方式优缺点、注意事项,以及常见并发症、相应处理措施。方法采用髂骨截骨联合股骨粗隆下截骨术,自2006年8月—2008年8月治疗65例83髋年龄在1.5~8周岁的发育性髋关节脱位患儿,术前行患肢皮肤牵引或骨牵引,必要时切断内收肌,术后石膏固定定时复查,平均随访23个月,分析结果探讨手术方式及疗效。结果所有患儿均取得12~41个月的随访,平均随访23个月,按照周永德等发育性髋关节脱位疗效评定标准进行评定,26~30分为优,21~25分为良,16~20分为可,11~15分为差,本组病例平均27.34分,优良率达86%,术后摄X线片:髋臼指数8°~28°,平均17°。结论发育性髋关节脱位应早期发现早期治疗,髂骨截骨联合股骨粗隆下截骨术治疗小儿发育性髋关节脱位效果良好。
Objective To investigate the curative effect of Salter iliac osteotomy combined with femoral subtrochanteric osteotomy for the treatment of children with developmental dislocation of the hip. The advantages, disadvantages, precautions, common complications and corresponding treatment measures were analyzed. Methods The iliac osteotomy and femur subtrochanteric osteotomy were performed. From August 2006 to August 2008, 65 children with developmental hip dislocation of 83 hip and 1.5 to 8 years old were treated. Skin traction or traction, if necessary, cut off the adductor, gypsum fixed regularly review, the average follow-up of 23 months, analysis of the results to explore the surgical approach and efficacy. Results All patients were followed up for 12 to 41 months and were followed up for an average of 23 months. The patients were evaluated according to the evaluation criteria of developmental dislocation of the hip joint such as Zhou Yongde. The scores of 26 to 30 were excellent, 21 to 25 were good, 20 points can be, 11 to 15 points for the poor, this group of patients average 27.34 points, excellent rate of 86%, postoperative radiography: acetabular index 8 ° ~ 28 °, an average of 17 °. Conclusion Developmental dislocation of the hip should be treated early and early treatment of iliac osteotomy combined with subtrochanteric osteotomy in children with developmental dislocation of the hip effect is good.