髋骨截骨术治疗成人髋关节半脱位

有症状的成人髋关节半脱位临床上并不罕见，手术治疗的种类多。为了评估髋骨截骨术的治疗效果，于１９８５年～１９９１年采用此术式治疗２６例，男１２例，女１４例。年龄２２岁～３８岁，平均２６．５岁。病程３年～６年，平均３．４年。原发病包括先天性髋关节脱位１２例，股骨头骨软骨病１０例，未确定４例。手术指征是有症状的髋关节半脱位，而且有一定宽度的关节间隙，一定范围的关节活动度，特别是有一定程度的头臼相称。术中采用新设计的髋臼移位方法———置术侧足于对侧股部，然后施力。根据临床和Ｘ线片检查评定疗效，优１１例，良１５例。认为，经选择的患者，髋骨截骨术是合适的，新的移位方法简便而有效

INNOMINATE OSTEOTOMY IN THE TREATMENT OF SUBLUXATION OF HIP IN ADULT

The symptomatic subluxation of hip is not uncommon in adults, and several kinds of surgical options are available. Twenty-six patients (26 hips) suffering from residual symptomatic subluxation of the hip were treated with innominate osteotomy during 1985 to 1991. The patients were followed-up for 4 to 9 years. The ages of the patients ranged from 22 to 38 years with an average of 26 years and 6 months. The duration of symptoms ranged from 3 to 6 years with an average of 3 years and 5 months. The pertinent prior diseases were the congenital dislocation of hip in 12 cases, Perthes disease in 10 cases, and in the remaining 4 cases, the causes were not identified. The indications for operative intervention were that presence of a reasonable articular cartilaginous space, a reasonable range of motion preserved and particularly a reasnable joint congruity must exist. A new method of re-alignment of the acetabulum was used to placing the ipsilateral foot on the contralateral thigh. The result was evaluated by the symptoms, the function of the hip and the radiographic findings. According to these criteria, the excellent results were obtained in 11 cases and the good result in 15 cases. It was suggested that the innominate osteotomy were also suitable for the treatment of residual symptomatic subluxation of hip in carefully selected adults and the new method of re-alignment of acetabulum was simple and effective.