Crowe Ⅳ型髋关节发育不良患者全髋关节置换术下肢长度平衡的调节

目的探讨CroweⅣ型髋关节发育不良（DDH）全髋关节置换术（THR）中肢体长度平衡的调整原则及方法。方法回顾性分析2009年7月—2012年6月行THR治疗的39例（41髋）CroweⅣ型DDH患者的临床资料，根据双髋脱位情况对其进行分型，按分型设计并实施手术，分析随访结果。结果根据双髋脱位情况分为4个亚型，其中Ⅰ型2例、Ⅱ型18例、ⅢA型6例、IIIB型9例、Ⅳ型4例。术前患者两下肢长度平均差异为5．1cm，术后为～1．4cm。患者随访时间12—36个月平均22．4个月。最终随访的平均SF-12健康评分为16分（区间为13～22分）。结论根据不同分型对CroweⅣ型DDH患者设计个体化重建手术方案，按设计方案可有效调整下肢长度差异。

Leg length adjustment in total hip replacement for patients with Crowe IV developmental dysplasia of the hip

Objective To discuss the leg length adjustment in total hip replacement （THR） for patients with Crowe IV developmental dysplasia of the hip （DDH）. Methods The clinical data of 39 Crowe IV DDH patients （41 hips） that accepted THR in our institute from July 2009 to June 2012 were retrospectively studied. Results The patients were divided into 4 types according to dislocation condition of bilateral hips. There were 2 cases of type Crowe I , 18 cases of type II , 6 cases of type IliA, 9 cases of type III B and 4 cases of type IV. The average preoperative leg length difference （LLD） was 5.1 cm, while postoperative LLD was - 1.4 cm. Patients were followed up at least 12 months （ average 22.4 months, 12 - 36 months）. The average SF-12 score of last follow up was 16 （13 -22）. Conclusion Planning the THR for Crowe IV patients according to our classification can effectively correct the preoperative leg length discrepancy.