Chiari骨盆内移截骨并加盖术治疗大龄儿童发育性髋关节脱位术后并发症分析

目的：对Chiari骨盆内移截骨并加盖术，部分合并股骨近端旋转戗骨治疗大龄儿童发育性髋天节脱位术后出现的并发症进行分析，并对其产生的原因进行分析，以期能找出降低术后开发症的办法和措施。方法：本组患儿42例，男10例，女32例，年龄6岁～16岁，平均9．2岁。采用髋关节前方切口，切开关节囊，找见真口，清理真门内软组织，复位股骨头于真臼内；真髋臼缘上方0．5cm处行骨盆完全截骨，髂骨块植入截骨处，行加盖，进一步增加股骨头的包容。部分患儿仃股骨近端旋转戡骨，纠正前倾角。结果：42例患儿经1-6年的随访（平均3．5年），出现再脱位3例，股骨头缺血性坏死2例，坐骨神经损伤1例，髋关节功能障碍4例。结论：Chiari骨盆内移截骨并加盖术虽然是治疗大龄儿童发育性髋关节脱位的一种较为有效的方法，但术后并发症的发生率较高。提示我们在术前一定要选择合适的病例，术中仔细操作，尽量避免并发症的发生。

Chiari Pelvic Osteotomy And Shelf Operation for Treatment of Developmental Dislocation of the Hip in Older Children

Objective： To evaluate the clinical effect of Chiari pelvic osteotomy and shelf operation in treatment of developmental disloeation of tile hip in eider children. Methods： There were 42 patients, 10 male and 32 female, with an average age of 9.2 years （range, 6-16 years old）, who underwent the procedure of opening articular capsule, finding the true acetahulum and cleaning up it, reducing femoral head into the true acetabulum, truncating the ilium completely 0.5 centimeter ahove the edge of true acetabulum, inlay the bone block which cut down from ilium to acctahulum superior border in order to enlarge the containment of femoral head. Some eases were circumrotated the approaching tip of femur in order to redress the anteversion angle. Results： All the cases were followed up for mean 3.5 years （ ranging from 1 year to 6 years）. There were 3 eases of redislocation, 2 cases of femoral head necrosis, 1 case of injury of sciatic nerve, 4 cases of hip joint functional disturhance after operation. Conclusion： Though Chiari pelvic osteotomy and shelf operation is an effeetive method for treating developmental dislocation of the hip in elder ehildren, the incidence rate of postoperative cnmplications is high. It hints us that we shouhl choose the suitable case before operation, manipulate earefully in the operation in order to avoid the complications.