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《經(jīng)髂骨內(nèi)側(cè)壁髖臼周圍旋轉(zhuǎn)截骨治療髖臼發(fā)育不良.pdf》由會員上傳分享，免費在線閱讀，更多相關(guān)內(nèi)容在應(yīng)用文檔-天天文庫。
1、·60·中國實用醫(yī)刊2014年8月第4l卷第15期ChineseJournalofPracfic~MedicineAug．2014，Vo1．41，N-l5經(jīng)髂骨內(nèi)側(cè)壁髖臼周圍旋轉(zhuǎn)截骨治療髖臼發(fā)育不良薛源馮香高化富張印峰【摘要】目的探討經(jīng)髂骨內(nèi)側(cè)壁髖臼周圍旋轉(zhuǎn)截骨術(shù)治療髖臼發(fā)育不良的療效。方法應(yīng)用經(jīng)髂骨內(nèi)側(cè)壁髖臼周圍旋轉(zhuǎn)截骨術(shù)治療髖臼發(fā)育不良患者36例。取髂腹股溝切口，在髂骨內(nèi)側(cè)壁骨膜下剝離，顯露髖臼底內(nèi)側(cè)壁，不要解剖髂內(nèi)血管神經(jīng)鞘，沿髖臼周圍1．5cm用骨鑿截骨，上緣平坐骨大切跡，下緣在恥骨梳及坐骨體
2、處，鑿穿雙層皮質(zhì)，但不要鑿穿外側(cè)骨膜，使髖臼成為一游離單位，用頇棒頂壓使其向前外及下方旋轉(zhuǎn)，矯正Shaq~角至35。左右，恢復(fù)股骨頭正常覆蓋率75％以上。自髂前上棘穿入2枚斯氏針頂壓在髖臼底內(nèi)側(cè)壁上。術(shù)后無需石膏固定。結(jié)果36例中31例術(shù)后隨訪7—82個月，平均22個月。參照Mckay評級法，療效優(yōu)2l例，良8例，差0例。結(jié)論經(jīng)髂骨內(nèi)側(cè)壁髖臼周圍旋轉(zhuǎn)截骨治療髖臼發(fā)育不良，方法簡單有效，創(chuàng)傷小，且對骨盆的穩(wěn)定性影響較小，內(nèi)固定可靠，不需石膏固定，減輕患者痛苦及避免石膏并發(fā)癥的發(fā)生?？傻骄徑饣俭y疼痛，避
3、免或延緩骨性關(guān)節(jié)炎的目的?！娟P(guān)鍵詞】髖臼發(fā)育不良；髖臼周圍旋轉(zhuǎn)截骨；斯氏針頂壓Periacetabularrotationalosteotomythroughthemedialwallofiliumforthetreatmentofacetabu-lardysplasiaXUEYuan，F(xiàn)ENGXiang，GAOHua，ZHANGYin-feng．DepartmentofHematolo—gY，People’SHospitalofZaozhuang，Zaozhuang277101，China【Abst
4、ract】ObjectiveToinvestigatetheeffectofperiacetabularrotationalosteotomythroughthemedialwallofiliumonacetabulardysplasia．MethodsThirty-sixpatientswithacetabulardysplasiawereoperatedwithperiacetabularrotationalosteotomythroughmedialwallofilium．Firstly，the
5、dissec-tionwasperformedinthesubperiostealplaneofthemedialiliumviatheilioinguinalincisiontoexposethemedialwallofthebottomofacetabulum．Secondly，withoutdissectingtheinternaliliacvasculoneuralsheaths，osteotomewasusedtocompletetheosteotomyaroundtheacetabulum
6、within1．5cm．Thesupe—riorportionwzisgreatersciaticnotchandtheinferiorportionwaspectenpubisandbodyofischium．Inor—dertoisolatetheacetabulum，thetwolayercorticalbonewascutthroughandwithoutdamagingthelater—alperiosteum．Thirdly，withthehelpofbiofixrods，theaceta
7、bulumwasrotatedanterolaterallyandinferi—orlytocorrecttheSharpangleto35。andtorestorethecoveragerateoffemoralheadto75％．Twostein-mannpinswereusedtoputpressureonthemedialwallofthebottomofacetabulumthroughanteriorSU-periorspine．Postoperatively，noneoftheopera
8、tedpatientswasimmobilized．ResultsThirty—oneofthetotal36patientshad7to82months(average22months)offollowup．AccordingtoMckaycriteria，theeffectwasexcellentin21casesandgoodin8cases．ConclusionsPeriacetabularrotationalosteotomythroughth
