全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
-  2015 

Bernese截骨术治疗成人髋关节发育不良疗效观察

DOI: doi:10.7507/1002-1892.20150180

Keywords: 髋关节发育不良, Bernese截骨术, 髋关节重建

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的探讨Bernese截骨术治疗成人髋关节发育不良(developmental dysplasia of the hip,DDH)的疗效。 方法回顾分析2012年8月-2014年4月,采用改良S-P入路Bernese截骨术治疗并获随访1年以上的16例成人DDH患者临床资料。男4例,女12例;年龄18~35岁,平均27.8岁。左髋6例,右髋10例。髋关节Harris评分为(81.2±5.4)分,疼痛视觉模拟评分(VAS)为(4.8±0.5)分。患侧髋臼外侧CE角(即股骨头中心点的垂线与髋臼外侧边缘的夹角)为(6.5±8.7)°,髋臼顶倾斜角为(25.6±5.9)°,股骨头超出指数为36.5%±6.5%。根据Tonnis骨关节炎分型,0期12例,Ⅰ期3例,Ⅱ期1例。 结果手术时间90~135 min,术中出血量400~800 mL,术后10例输血200~600 mL,术后引流量100~300 mL,住院时间7~12 d。术后切口均Ⅰ期愈合。2例术后出现股外侧皮神经支配区感觉麻木。16例患者均获随访,随访时间12~26个月,平均20个月。X线片复查示,截骨端均骨性愈合,愈合时间12~16周,平均13.5周。随访期间无髋臼骨折、异位骨化、骨坏死、内固定物松动等并发症发生;骨关节炎均无进展,未见髋臼囊性变。末次随访时,患侧髋臼外侧CE角为(27.7±6.8)°、髋臼顶倾斜角为(16.2±4.8)°、股骨头超出指数为19.7%±5.3%,VAS评分为(0.8±0.3)分,髋关节Harris评分为(96.8±6.7)分,与术前比较差异均有统计学意义(P<0.05)。 结论对于成人DDH患者,Bernese截骨术可有效增加髋臼包容,改善关节功能,延缓骨关节炎进展,近期疗效良好

References

[1]  1. 朱建辛,王跃,庞健,等.人工全髋关节置换术治疗重度成人髋关节育不良疗效分析.中国修复重建外科杂志,2014,28(3):335-338.
[2]  18. Pogliacomi F,Stark A,Wallensten R.Periacetabular osteotomy.Good pain relief in symptomatic hip dysplasia,32 patients followed for 4 years.Acta Orthop,2005,76(1):67-74.
[3]  19. Clohisy JC,Barrett SE,Gordon JE,et al.Periacetabular osteotomy for the treatment of severe acetabular dysplasia.J Bone Joint Surg (Am),2005,87(2):254-259.
[4]  4. Lee CB,Millis MB.Alternatives to periacetabular osteotomy for adult acetabular dysplasia.Instr Course Lect,2013,62:287-295.
[5]  5. Tibor LM,Sink EL.Periacetabular osteotomy for hip preservation.Orthop Clin North Am,2012,43(3):343-357.
[6]  8. Leunig M,Ganz R.Bernese periacetabular oseotomy.Current Orthopaedics,2007,21(2):100-108.
[7]  9. Okano K,Enomoto H,Osaki M,et al.Outcome of rotational acetabular osteotomy for early hip osteoarthritis secondary to dysplasia related to femoral head shape:49 hips followed for 10-17 years.Acta Orthop,2008,79(1):12-17.
[8]  17. Redmond JM,Gupta A,Stake CE,et al.The prevalence of hip labral and chondral lesions identified by method of detection during periacetabular osteotomy:arthroscopy versus arthrotomy.Arthroscopy,2014,30(3):382-388.
[9]  2. 李永旺,马文海,孙俊英,等.BeckerⅤ形外旋截骨在Crowe Ⅳ型发育性髋关节脱位人工全髋关节置换术中的应用.中国修复重建外科杂志,2013,27(9):1032-1036.
[10]  3. Ganz R,Klaue K,Mast J.Peri-acetabular reorientation osteotomy.Acta Orthop Belg,1990,56(1 Pt B):357-369.
[11]  6. Lara J,Tobar C,Besomi J.Bernese periacetabular osteotomy for hip dysplasia.A modification to original technique and South American perspective.Curr Rev Musculoskelet Med,2014,7(4):337-341.
[12]  7. Tonnis D.Clinical and radiographic schemes for evaluating therapeutic results//Tonnis D.congenital dysplasia and dislocations of the hip in children and adults.Berlin:Springer-Verlag,1987:165-171.
[13]  10. Kiyama T,Naito M,Shiramizu K,et al.Ischemia of the lateral femoral cutaneous nerve during periacetabular osteotomy using Smith-Petersen approach.J Orthop Traumatol,2009,10(3):123-126.
[14]  11. Naito M,Nakamura Y.Curved periacetabular osteotomy for the treatment of dysplastic hips.Clin Orthop Surg,2014,6(2):127-137.
[15]  12. Novais EN,Kim YJ,Carry PM,et al.The Bernese periacetabular osteotomy:is transection of the rectus femoris tendon essential? Clin Orthop Relat Res,2014,472(10):3142-3149.
[16]  13. Steppacher SD,Tannast M,Ganz R,et al.Mean 20-year follow-up of Bernese periacetabular osteotomy.Clin Orthop Relat Res,2008,466(7):1633-1644.
[17]  14. Ziebarth K,Balakumar J,Domayer S,et al.Bernese periacetabular osteotomy in males:is there an increased risk of femoroacetabular impingement (FAI) after Bernese periacetabular osteotomy? Clin Orthop Relat Res,2011,469(2):447-453.
[18]  15. Zhu J,Chen X,Cui Y,et al.Mid-term results of Bernese periacetabular osteotomy for developmental dysplasia of hip in middle aged patients.Int Orthop,2013,37(4):589-594.
[19]  16. Keel MJ,Ecker TM,Siebenrock KA,et al.Rationales for the Bernese approaches in acetabular surgery.Eur J Trauma Emerg Surg,2012,38(5):489-498.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133