改良Zahradnicek手术治疗大龄儿童发育性髋脱位临床应用研究

目的:探讨7～12周岁大龄儿童发育性髋脱位(DDH)治疗优化方法,减少并发症。方法:自2005～2011年应用改良Zahradnicek手术治疗大龄儿童发育性髋脱位37例、41个关节,用特制的小儿髋臼钻有限切削臼软骨,重建髋臼孤形结构,恢复其头臼同心圆关系,同时矫正前倾角至5°～10°,颈干角至120°,用专用的120°鹅颈钢板固定。结果:术后疗效评定:优22髋,为54%;良14髋,为34%;可3髋,为7%;差2髋,为5%,优良率占88%。结论:此种手术在1次手术中使股骨头、髋臼、股骨颈及股骨干恢复或接近恢复正常解剖和功能的方法,使大年龄DDH患儿获得一个功能良好、稳定无痛的关节。

Clinical Application of Treatment of Developmental Dysplasia of the Hip in Older Children with Improved Zahradnicek Operation

Objective:To discuss the best methods to treat Developmental Dysplasia of the Hip in older children anddecrease the complications.Methods:41 joints of 37 cases congenital hip joint dislocation were underwent improved Zahradnicek operation.The re-construction of acetabulum arch structure were made to restore the concentric relation between head and acetabulum withspecial drill meanwhile corrected anteversive angle 5～10° and cervical shaft angle 120° with curved steel fixed.Results:The curative assessment were 22 joints excellent,14 joints good and 5 joints bad effects.The curative ratio was 88%.Conclusion:This methods could completely or nearly restore the hip joint to normal anatomic and functional position.