Salter骨盆截骨术后并发症原因分析
Investigation on causes of complications after Salter’s innominate osteotomy in developmental dislocation of hip
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摘要: 目的: 探讨Salter骨盆截骨术治疗发育性髋脱位术后发生并发症的原因。方法: 对Salter骨盆截骨术治疗发育性髋脱位术后发生并发症的14例16个髋关节的临床资料进行分析,其中再脱位5个髋、僵硬5个髋、再脱位+头坏死3个髋、僵硬+头坏死3个髋。结果: 手术适应证掌握不当发生髋关节再脱位2个髋,僵硬4个髋。未进行股骨近端短缩截骨发生头坏死6个髋,其中伴再脱位3个髋、僵硬3个髋。克氏针固定造成髋臼指数丢失发生再脱位2个髋,截骨后缘张开导致再脱位1个髋和僵硬1个髋。结论: Salter骨盆截骨术的适应证及技术要领掌握不当、头臼压力过大是造成术后发生并发症的主要原因。Abstract: Objective: To investigate the causes of complications after Salter′s innominate osteotomy in developmental dislocation of hip.Methods: Fourteen patients with 16 hips of complications after Salter′s innominate osteotomy were investigated.Five hips were redislocation,and 5 hips stillness,and 3 hips redislocation with avascular necrosis,and 3 hips stillness with avascular necrosis.Results: The unapt indications caused redislocation in 2 hips and stillness in 4 hips.Failure to shorten femur caused 6 hips avascular necrosis with 3 hips redislocation and 3 hips stillness.The smooth Kirschner wire for fixation caused redislocation in 2 hips.The innominate osteotomy,which was keeping open at the posterior edge caused redislocation in 1 hip and stillness in 1 hip.Conclusion: Unskillfull Surgical management,unapt indication and overpressure between the femoral head and the acetabulum are main keys to complications after Salter′s innominate osteotomy in developmental dislocation of hip.
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