Chiari截骨加髋臼造盖术治疗高龄儿童先天性髋关节脱位

目的：探讨Ｃｈｉａｒｉ截骨加髋臼造盖术治疗先天性髋关节脱位的疗效。方法：分析４２例高龄儿童先天性髋关节脱位，采用单纯Ｃｈｉａｒｉ截骨治疗１５ 例，Ｃｈｉａｒｉ截骨加髋臼造盖术治疗２７ 例的临床资料。结果：随访４０ 例中，单纯Ｃｈｉａｒｉ截骨１３ 例，Ｃｈｉａｒｉ截骨加髋臼造盖术２７ 例，术后髋臼指数１４°～３２°，平均２６°。前倾角２５°～４０°，平均２８°。颈干角１３４°～１４６°，平均１３６°。单纯Ｃｈｉａｒｉ截骨优良率为６９．２％ ，３ 例发生股骨头缺血性坏死，１ 例发生头臼骨质硬化。Ｃｈｉａｒｉ截骨加髋臼造盖术的优良率为８８．８％ ，无股骨头缺血性坏死的发生。Ｃｈｉａｒｉ截骨加髋臼造盖术由于髋臼指数能得到有效的纠正，股骨头复盖接近正常，能很好的恢复正常的髋关节的生物力学关系，因此是治疗高龄儿童先天性髋关节脱位的有效方法之一。

Chiari pelvic osteotomy and grafting Innominate cap to treat the congenital dislocation of the hip in elder children

s Purpose:To investegate the outcome of the treatment of the congenital dislocation with Chiari pelvic osteotomy and grafting innominate cap.Methods:42 elder children involved to the congenital dislocation of the hip.15 cases were treated with Chiari pelvic osteotomy.27 cases were treated with Chiari pelvic osteotomy and grafting innominate cap.Results:40 cases were follow-up.13 cases were treated with Chiari pelvic osteotomy.27 cases were treated with Chiari pelvic osteotomy and grafting innominate cap.The results were found:The acetabular anter-slope angle ranged from 14 to 32 degrees,average in 26 degree.The acetabular coefficient ranged from 25 to 40 degres,average in 28 degree.The neck shaft angles ranged from 134 to 146 degrees,average in 136 degree.In the group treated with Chiari pelvic osteotomy.The excellent and good rate was 69.2%.The avascular necrosis occurred in 3 cases.The acetabular ossifican occurred in one case.In the group to treat with Chiari pelvic osteotomy and grafting innominate cap,The excellent and good rate was 88.9%.We have not found the avascular necrosis.Conclusion:It is an effective method on remedy the acetabular coefficeint by acetabular mortar and correlate to acetabular biomechainics to treat the congenital dislocation of the hip in older children with Chiari pelvic osteotomy and grafting innominate cap.