髋关节外科脱位入路在髋关节良性疾病的应用

目的  探讨髋关节外科脱位入路在髋关节良性疾病应用的早期临床疗效。方法  选取2013年1月-2014年12月中南大学湘雅二医院收治的27例髋关节良性疾病病例。所有病例均在术前收集详细的病历资料并行放射学检查，由同一高年资关节外科医生运用髋关节外科脱位入路进行手术。术后6、12及24个月均行X-Ray检查以明确是否出现股骨头缺血坏死、病变复发以及继发性骨关节炎。所有病例均获得至少1年的最终随访，并行Harris髋关节功能评分。结果  术后证实，26例（27髋）髋关节良性疾病包括：13例髋关节后脱位并股骨头骨折，8例髋股撞击综合征，3例滑膜软骨瘤病，1例股骨头骨骺滑脱（双侧）和1例化脓性关节炎。平均随访18个月，所有病例均未出现复发、大粗隆截骨不愈合以及股骨头缺血坏死等，术后Harris髋关节功能评分均为优良。结论  应用髋关节外科脱位入路治疗髋关节良性疾病能获得良好的显露，并能最大程度保护股骨头血运，早期临床疗效满意。

Application of surgical hip dislocation approach in hip Benign Diseases

Objective To assess the early clinical outcomes of surgical hip dislocation approach applied in hip benign diseases. Methods Cases with hip benign diseases in our department from January 2013 to December 2014 were reviewed. Data were collected prospectively. All patients were perfomed radiological investigation before surgery. Surgical hip dislocation was carried out by the senior surgeon in all cases. All cases were examined with radiograph after postoperative 6, 12 and 24 months to evaluated relative complications. All patients werefollowed up at least 1 year and the Harris hip scores were done at the final follow-up. Results There were 26 cases (27 hips) of benign diseases in this series, including femoral head fracture (13), femoroacetabular impingement (8), synovial chondromatosis (3), slipped capital femoral epiphysis (1), septic hip diseases (1). No recurrences, trochanteric nonunion and avascular necrosis were found up to a mean 18 months follow-up. Harris hip scores were all good or excellent. Conclusions Surgical hip dislocation is a useful approach which can obtain good exposure of intra-articular structure in hip joint and prevent effectively the blood supply of femoral head.