摘要
目的介绍一种新的骨盆截骨即髋臼坐骨切迹周围骨盆截骨操作技术,并初步评价治疗儿童发育性髋关节脱位(Development Dysplsia of the Hip,DDH)的临床疗效。方法骨盆截骨线起自髂前上、下棘中点,与髋臼后上缘平行,并向髋臼后下方延长,止于距离坐骨切迹骨皮质3～5mm处,撑开截骨间隙时产生坐骨切迹皮质不完全性骨折,获得髋臼向前外方向的旋转,再用自体或异体楔形骨块嵌入截骨间隙,从而实现改变髋臼方向和增加对股骨头覆盖的目标。结果我院自2002年以来创用该术式治疗儿童发育性髋关节脱位64例(76髋)。对随访时间大于2年的12例14髋,按照McKay髋关节评定标准和Severin放射学分类评价标准评价其疗效,优12髋,良2髋。结论髋臼坐骨切迹周围骨盆截骨兼有Salter和Pemberton骨盆截骨的优点,但手术操作更为安全简便,适应征也比较宽泛。
Objective To describe a new procedure of pelvic osteotomy with periacetabular-sciatic notch for developmental dislocation of the hip （DDH） and its clinical efficacy in children. Method The cutting line was started in middle point between the anterior and inferior iliac spine and proceeded parallel with posterior-superior edge of acetabulum extending as far as the posterior-inferior of acetabulum and then ended straightly 3mm to 5mm anterior to the cortex of sciatic notch. After finishing the cutting with a narrow straight osteotome,laminar spreader was inserted into the gap of iliac osteotomy in order to open the osteotomy and to produce deliberately incomplete fracture of sciatic notch,which was the hinge for obtaining forwardd-outward lateral rotations of the acetabulum. Therefore a wedge of either from a concomitant femoral bone shorted with amputation or from allograft was inserted in the opening keeping stability of the iliac osteotomy. Results 64 cases （76 hips） with DDH in children were performed with this procedure. Among which,12 cases（14hips） were followed up for 26～60 months （averaged 41 months）. According to the Mackay clinical classification and Severin X-ray classification of outcome,12 hips were excellent and 2 good. Conclusion The pelvic osteotomy of periacetabular-sciatic notch is one new combination pelvic osteotomy which have advantages of both Salter and Pemberton pelvic osteotomy and more easily to perform than Pemberton,Salter or Westin pelvic osteotomy. This procedure can be widely used in infantile and younger children with DDH.
出处
《临床小儿外科杂志》
CAS
2007年第4期6-9,共4页
Journal of Clinical Pediatric Surgery
作者简介
E-mail：meihaibo@sina.com .
