联合手术治疗较大儿童先天性髋脱位

应用一期联合手术，包括软组织彻底松解，切开复位关节囊成形，股骨上端截骨术和骨盆截骨，治疗较大儿童先天性髋脱位４９例６４髋，其中男１２例１５髋，女３７例５４髋。手术时年龄２．５岁～１１岁，平均６岁５个月。６岁以上２５例３０髋。随访时间为１～１４．５年，其中５年以上３０例４６髋。随访结果：优３５髋（７６．１％），良６髋（１３．０％），可５个关节（１０．９％）。并发症有股骨头坏死２例，术后剧烈被动活动继发骨化性肌炎１例。笔者认为，通过联合手术使股骨头完全复位、术后尽早活动、彻底松解软组织和股骨充分缩短对预后有重要意义。

Combined Operation to Treat Elder Children with Dislocation of Hip.

Forty nine(64 hips)of elder children with CDH were treated by combined operations in one stage,including complete release of soft tissue,open reduction and capsuloplasty,osteotomy of proximal femur and pelvic osteotomy.The cases consisted of 12 males(15 hips)and 37 females(54 hips),the average age was 6 years and 5 months(2 5 11 years old), 25 cases(30 hips)were over the age of 6.The follow up period ranged from l to 14.5 years,it was longer than 5 years in 30 cases(46 hips)Results showed:excellent in 35 hips(76 1%),good in 6 hips(13 0%),fair in 5 hips(10 9%).The complications of femoral head necrosis were found in 2 cases and secondary myositis ossificans in 1.The authors emphysize that the complete reduction by combined oprations,early postoperative mobilization,complete release of soft tissue and adequate shortening of femur are significant to the prognosis.