儿童双侧病理性髋关节脱位的髋关节成形术

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详细

论证。低龄儿童的病理性髋关节脱位是股骨近端干骺端血源性骨髓炎及败血性关节炎最严重的并发症。若双侧髋关节同时受累,将导致解剖与功能障碍变得更加严重,因此需要付出额外努力进行矫正。这类患者的康复过程往往需多年,不仅包括手术矫正,还需持续的保守治疗。严格遵循康复方案极为重要,否则治疗不足或不当,将导致关节挛缩、髋关节活动受限,甚至加重继发畸形。

目的。分析采用脱矿骨软骨同种异体移植进行髋关节成形术治疗儿童双侧病理性髋关节脱位的手术效果,并关注康复阶段的特点,以获得良好的近期及远期术后结果。

材料与方法。分析了11例(共22个关节)1.5–10岁双侧破坏性病理性髋关节脱位儿童的手术治疗结果,手术采用脱矿骨软骨同种异体移植行髋关节成形术。

结果。在远期随访(1–12年)期间,在大多数(86.4%)经X线证实稳定的手术侧髋关节中,观察到屈曲活动度保持不少于80°。

结论。采用脱矿骨软骨同种异体移植进行髋关节成形术,可能是治疗儿童破坏性病理性髋关节脱位的一种有效方法,能够在较长时间内维持髋关节的稳定性及活动度。在儿童双侧髋关节病变的情况下,采取连续性、系统性和综合性的治疗措施,是实现康复成功、以及恢复和维持患侧关节功能的关键因素。

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作者简介

Yuriy E. Garkavenko

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; North-Western State Medical University named after I.I. Mechnikov

编辑信件的主要联系方式.
Email: yurijgarkavenko@mail.ru
ORCID iD: 0000-0001-9661-8718
SPIN 代码: 7546-3080
http://www.famous-scientists.ru/list/10440

MD, PhD, Dr. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg; Saint Petersburg

参考

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2. Fig. 1. X-ray images of the patient’s hip joints at various stages of surgery.

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3. Fig. 2. External appearance (a) and functional capacity of the hip joints (b, c); negative Thomas test on both sides (d, e); and X-ray images of the hip joints (f) during the long-term follow-up.

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