发育性髋脱位治疗后继发股骨头坏死的治疗

Treatment for avascular necrosis of femoral head after closed reduction of developmental dislocation of the hip

  • 摘要: 目的: 探讨发育性髋关节脱位治疗后继发股骨头坏死的治疗方法。方法: 采用松手抱及骑小三轮车活动的方法治疗发育性髋关节脱位治疗后早期头坏死24例32髋。头坏死修复后选择Staheli髋臼延伸术7髋、Salter骨盆截骨术3髋、Pemberton髋臼成形术1髋。结果: 32个髋中11个半脱位的髋获得中心性复位。11个手术的髋关节中,临床效果优者7髋、良者4髋;X线片示优者4髋、良者5髋、中者2髋。10个未复位的髋关节仍在继续观察中。结论: 松手抱及骑小三轮车活动是治疗发育性髋关节脱位治疗后早期头坏死的有效方法之一,手术治疗时机应选在头坏死修复后进行。

     

    Abstract: Objective: To investigate treatment methods for avascular necrosis of femoral head after closed reduction of developmental dislocation of the hip. Methods: Twenty-four cases of patients with 32 hips were treated in early stage of avascular necrosis after closed reduction of developmental dislocation of the hip by their mothers carrying them on the back.Three months later the patient began to ride small tricycle.The open reduction was performed after the restoration of avascular necrosis.Seven hips were dealed with Staheli’s acetabular augmentation,3 hips with Salter’s innominate osteotomy,1 hip with Pemberton’s osteotomy. Results: 11 hips that were in the position of subluxation got central reduction in 32 hips.7 hips got excellent clinical results and 4 hips good results in the open reduction of 11 hips.The X-ray photos showed that 4 hips got excellent results,5 good results and 2 fair results.Ten hips need to be observed. Conclusion: The method of carrying patient on the back and riding small tricycle is one of the effective methods for avascular necrosis in early stage after closed reduction of developmental dislocation of the hip.The open reduction should be performed after the restoration of avascular necrosis.

     

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