| 全髋关节置换术治疗成人Crowe Ⅳ型先天性髋关节发育不良的近期疗效 |
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Received:May 20, 2016
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| 作者 | Author | 单位 | Unit | E-Mail |
| 陈先军 |
CHEN Xian-jun |
宁波第二医院骨科, 浙江 宁波 315010 |
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China |
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| 刘丙根 |
LIU Bing-gen |
宁波第二医院骨科, 浙江 宁波 315010 |
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China |
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| 庞清江 |
PANG Qing-jiang |
宁波第二医院骨科, 浙江 宁波 315010 |
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China |
pqjey@sina.com |
| 余霄 |
and YU Xiao |
宁波第二医院骨科, 浙江 宁波 315010 |
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China |
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| 期刊信息：《中国骨伤》2016年29卷，第8期，第718-722页 |
| DOI：10.3969/j.issn.1003-0034.2016.08.009 |
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| 目的：探讨成人CroweⅣ型先天性髋关节发育不良行全髋关节置换术的手术方法和近期临床疗效。方法：2010年3月至2015年3月对20例20髋成人CroweⅣ型先天性髋关节发育不良行全髋关节置换术，其中男4例，女16例；年龄32～68岁，平均52岁。髋臼侧均采用生物型假体在真臼水平植入，股骨侧采用S-R0M假体结合股骨粗隆下横断截骨短缩行人工关节置换术，对临床结果采用改良Harris评分进行评价，术前及术后随访时均拍X线片进行观察。结果：患者切口均Ⅰ期愈合，无髋关节脱位、静脉血栓发生。所有患者获随访，时间8～60个月，平均38.1个月。术后X线片显示髋臼假体均位于真臼内，无髋臼假体松动。股骨侧截骨处均骨性愈合，Harris评分由术前平均（50.90±9.35）分提高至末次随访的（90.25±3.16）分，差异有统计学意义（P<0.05）.有1例术中发生小转子劈裂，1例术后出现坐骨神经损伤症状，1例出现 BrookerⅠ型异位骨化，所有患者术后髋关节活动度好，疼痛基本消失。结论：应用S-ROM 假体结合粗隆下截骨全髋关节置换术是治疗成人Crowe Ⅳ型先天性髋关节发育不良的有效手术方法，近期临床疗效满意。 |
| [关键词]:髋脱位,先天性 截骨术 关节成形术,置换,髋 |
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| Short-term clinical outcome of total hip arthroplasty for the treatment of Crowe Ⅳ congenital dysplasia of the hip in adults |
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| Abstract:Objective: To evaluate the short-term clinical effects and surgery methods of the total hip arthroplasty(THA)for the treatment of Crowe type Ⅳ congenital dysplasia of hip(CDH) in adults. Methods: From March 2013 to March 2015,20 patients (20 hips) with Crowe type Ⅳ CDH in adults were underwent THA,including 4 males and 16 females,with an average age of 52 years old ranged from 32 to 68 years old. All the cementless acetabular cups were placed at the original anatomic location. S-ROM prosthesis was adopted together with subtrochanteric transverse osteotomy in femoral side. All the patients were evaluated by using the Modified Harris Hip Score. Radiographic evaluations were made preoperatively and during follow-up. Results: The incisions were healed by first intention. There was no hip dislocation events and venous thrombosis occurred. All patients were followed up for 8 to 60 months with an average of 38.1 months. Postoperative X-ray films showed all acetabular prosthesis were in true acetabulum. No nonunion and loosening were found in all patients. Harris score at final follow-up improved from preoperative 50.90±9.35 to postoperative 90.25±3.16. The difference was statistically significant(P<0.05). There were 1 patient with femoral split fracture,1 patient with nerve injury,1 patient with heterotopic ossification of BrookerⅠ. The hip function of all patients was good,the pain was disappeared. Conclusion: THA with S-ROM prosthesis and subtrochanteric osteotomy is an effective method for the treatment of Crowe type Ⅳ CDH in adults. The recent clinical curative effect is satisfied. |
| KEYWORDS:Hip dislocation,congenital Osteotomy Arthroplasty,replacement,hip |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈先军,刘丙根,庞清江,余霄.全髋关节置换术治疗成人Crowe Ⅳ型先天性髋关节发育不良的近期疗效[J].中国骨伤,2016,29(8):718~722 |
| 英文格式: | CHEN Xian-jun,LIU Bing-gen,PANG Qing-jiang,and YU Xiao.Short-term clinical outcome of total hip arthroplasty for the treatment of Crowe Ⅳ congenital dysplasia of the hip in adults[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(8):718~722 |
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