髋臼侧截骨联合股骨侧截骨术治疗儿童髋关节发育不良的临床疗效

Clinical study of acetabular osteotomy combined with femoral osteotomy in treatment of developmental hip dysplasia in children

摘要:

目的 探讨髋臼侧截骨联合股骨侧截骨术治疗儿童髋关节发育不良（DDH）的临床效果。方法 选取南昌市洪都中医院DDH患儿50例，采用回顾性研究方案，按手术方式不同将患儿分为对照组（髋臼侧截骨术）及观察组（髋臼侧截骨联合股骨侧截骨术），每组25例。比较两组手术指标及术后恢复效果。结果 两组患儿手术时间、术中出血量比较，差异无统计学意义（P >0.05）。两组患儿术后中心边缘角（CE角）、前倾角度、髋臼指数及Makay评分比较，差异有统计学意义（P <0.05）。观察组术后CE角大于对照组，前倾角度、髋臼指数小于对照组（P <0.05）。观察组术后Makay评分高于对照组（P <0.05）。结论 髋臼侧截骨联合股骨侧截骨术治疗患儿DDH获得明显效果，创伤小、出血量少，能够使髋臼穹隆有效塑形，改善患儿髋臼功能，临床价值高，值得推广。

Abstract:

Objective To investigate the clinical effect of acetabular osteotomy combined with femoral osteotomy in the treatment of childhood developmental hip dysplasia (DDH).Methods The design method of this study was a retrospective research. Fifty children with developmental hip dysplasia who met the admission conditions of this hospital were selected and divided into the control group (acetabular side osteotomy) and the observation group (acetabular side osteotomy), according to different surgical methods. The surgical indicators and postoperative recovery effects were compared between the two groups.Results There was no statistically significant difference in operation time and intraoperative blood loss between the two groups (P > 0.05). Postoperative CE Angle, forward Angle, acetabular finger, and Makay scores were compared between the two groups, and the differences were statistically significant (P < 0.05). The postoperative CE angle of the observation group was higher than that of the control group, and the anteversion angle and acetabular index were lower than those of the controlgroup, both with statistically significant (P < 0.05). The Makay score in the observation group was higher than that in the control group (P < 0.05).Conclusion The acetabular lateral osteotomy combined with femoral lateral osteotomy has obvious effects on the developmental hip dysplasia in children, with less trauma and less bleeding. It is technology worth promoting that can effectively shape the acetabular vault and improve the acetabular function in children.