缝匠肌髂骨瓣翻转固定修复髋臼缺损治疗发育性髋脱位

目的总结缝匠肌骨瓣翻转固定修复髋臼缺损治疗发育性髋脱位的初步疗效.方法18例(20髋)髋臼严重缺损性发育性髋脱位,均行关节囊切开复位、股骨近端粗隆间短缩内翻旋转截骨角钢板固定、带缝匠肌髂骨瓣翻转螺钉固定髋臼缺损修复术,术后双下肢贝氏石膏固定1.5个月.按McKay临床功能及Severin X线标准进行疗效评价.结果16例(18髋)患儿取得完整随访资料,随访时间为4-37个月,平均22.8个月.患儿18例均为女性,年龄4-13岁,平均6.1岁.McKay临床功能评定、Severin X线标准评定,优良率均为89%.结论缝匠肌髂骨瓣翻转固定修复髋臼缺损为活骨移植,成骨效果好,愈合快,对难处理的髋臼严重缺损性发育性髋脱位治疗有效.

Overturned sartorius iliac flap in repair of acetabular defect in developmental hip dislocation

Objective To report the preliminary curative effect of overturned sartorius iliac flap in repair of acetabular defect in developmental hip dislocation(DHD).Methods Eighteen patients(20 hips) with severe acetabular defect in DHD were treated with open reduction of joint capsule,shortening and fixation of proximal femur tuberosity with steel plates,and overturned sartorius iliac flap.The lower extremities were fixed with plaster for 45 days after operation.The clinical outcomes were assessed according to the McKay functional and Severin radiograph standards,respectively.Results Sixteen female patients(18 hips) aged 4-13 years(mean 6.1 years) were followed up for 4-37 months(mean 22.8 months).The excellent rate was 89% according to the McKay functional and Severin radiograph standards.Conclusion The overturned sartorius iliac flap can effectively promote bone healing and repair acetabular defect in severe DDH.