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[目的]探讨大龄(8～13岁)DDH有效术式。[方法]行Smith-Peterson切口,显露髂骨外板至坐骨大切迹,内板显露前1/4和耻骨上枝近缘;在真臼上缘环绕髋臼向内、后用弧形骨凿截骨;距离坐骨大切迹1 cm弧向坐骨,向内弧向Y形软骨;逐渐下压远端使截骨间隙张开,取三角骨块楔入植骨。关节囊切除近端多余部分,使T形变V形端端缝合。股骨近端短缩旋转截骨视股骨头上缘与髋臼上缘距离短缩。术后3周去石膏裤固定,CMP练习髋关节活动。[结果]2001年11月～2008年9月治疗7例8岁以上发育性髋脱位随访平均18个月,髋关节平均伸屈活动范围在90°以上;肢体短缩平均1.2 cm。[结论]Pemberton骨盆截骨术改进用于大龄(8～13岁)DDH,在恢复髋关节的生理位置和关节活动功能、保留肢体长度、减少创伤和并发症、缩短治疗时间和费用等方面有其他术式不能替代的优势,是一种有效的术式。
[Objective] To explore the effective method of DDH in older adults (8 ~ 13 years old). [Method] The Smith-Peterson incision was performed to reveal the large outer notch of the iliac crest to the ischial bone. The inner plate was exposed to the top 1/4 and the upper margin of the suprapubic branch. The upper edge of the acetabulum was surrounded by the acetabulum, Bone; distance 1 cm from the ischia notch arc to the ischial, inward arc to the Y-shaped cartilage; gradually under the distal end of the osteotomy space open, take triangular bone wedging bone graft. Joint capsule resection of the proximal excess part of the T-shaped V-shaped end of the suture. Proximal femoral rotation of the osteotomy as the femoral head and acetabulum on the edge of shortening. 3 weeks after surgery to plaster pants fixed, CMP exercises hip activity. [Results] The follow-up of 7 patients with developmental dislocation over the age of 8 years from November 2001 to September 2008 was 18 months. The range of average flexion and extension of hip joint was over 90 °. The limb shortening was 1.2 cm on average. [Conclusion] Pemberton pelvic osteotomy is used to improve DDH in older adults (8-13 years old). It has the following functions in restoring the physiological position and joint function of the hip joint, keeping limb length, reducing the trauma and complications, shortening the treatment time and cost Other surgical advantages can not be replaced, is an effective surgical procedure.