摘要
目的比较比基尼切口与Smith-Peterson切口(S-P切口)行Salter手术治疗儿童发育性髋关节脱位(DDH)的疗效和优缺点。方法 2008年7月-2009年7月本院共收治DDH患儿45例,随机分为2组,分别使用S-P切口(27例,S-P切口组)和比基尼切口(18例,比基尼切口组)行Salter骨盆截骨手术治疗,根据股骨颈前倾角情况决定是否行股骨近端旋转截骨或旋转短缩截骨术,术后行骨盆前后位X线摄片观察临床疗效,以髋臼指数(AI)及中心边缘角(CE角)评价疗效,并比较治疗效果差异。结果术后骨盆前后位X线摄片评定手术效果,比基尼切口组CE角优良17例,欠佳1例;S-P切口组CE角优良26例,欠佳1例。用Severin标准评价CE角术后优良率,二组比较差异无统计学意义(χ2=0.1545,P>0.05)。AI均改善明显。但比基尼切口组未发现术中股外侧皮神经损伤,切口美观且隐蔽,家长易于接受,行股骨旋转截骨者股骨内固定钢板符合张力带原则,截骨处固定稳固,骨折易愈合。结论比基尼切口内行Salter骨盆截骨术与S-P切口比较治疗儿童DDH临床疗效确切,且切口安全、美观,术后对关节功能影响小。
Objective To compare the efficacy, advantages and disadvantages of Bikini cut and Smith - Peterson cut （ S - P cut） treat- ment for childhood developmental dislocation of hip（DDH）. Methods Forty - five cases （ from Jul. 2008 to Jul. 2009） with DDH in Nanjing Children＇s Hospital Affiliated to Nanjing Medical University were randomly divided into 2 groups,which were either treated with Salter pelvic osteotomy incision surgery through S - P cut （27 cases） or Bikini cut （ 18 cases） ,respectively. Then decision was made as whether or not to carry proximal femur rotation （crispation） osteotomy by judging from anteversion of femoral neck. Clinical efficacy was measured by acetabular index（AI） and center edge（CE） angle through X - ray. Results Judging from the X - ray photograph in terms of CE angle of Bikini cut group, 17 cases were excellent and 1 case was poor; in terms of CE angle of S - P cut group,26 cases were excellent and 1 case was poor, and the improvement of the A1 was significant,judging the postoperative excellence rate of CE angle by Severin standard,there was no significant difference between 2 groups in clinical efficacy by statistical test （X2 = 0. 154 5,P 〉 0.05 ）. But in Bikini cut group,there was no intraoperative lateral femoral cutaneous nerve injury, and operation cut was so hidden and so parents were willing to accept the operation. If it was hecessary to carry out femur rotation osteotomy and internal fixation of femur, the steel plate accords with the principle of tension band, so the fixation could be stable and the fracture can easily heal up. Conclusions In the treatment of DDH, Salter pelvic osteotomy through Bikini cut has exact clinical efficacy comparing with S -P cut,and its operation cut is safe,hidden,and there is rare injury to joint function after operation.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2010年第11期823-825,共3页
Journal of Applied Clinical Pediatrics
关键词
比基尼切口
发育性髋关节脱位
治疗
Bikini cut
developmental dislocation of hip
treatment
作者简介
作者简介：倪磊，男，住院医师，学士学位，研究方向为骨科，电子信箱nilei790709@sohu．com。
