摘要目的 探讨髋臼重建及股骨转子下短缩横行截骨全髋关节置换治疗高原地区CroweⅣ型成人发育性髋关节发育不良(displasia dislocation of the hip，DDH)的临床疗效。方法 2009年5月至2013年5月收治14例(15髋)Crowe Ⅳ型成人DDH患者，其中男4例(4髋)，女10例(11髋)；年龄23～56岁，平均(36±8)岁。实施髋臼重建、股骨转子下横行短缩截骨全髋关节置换术。髋臼采用生物性臼杯，股骨采用SROM生物假体，均为陶瓷-陶瓷界面，以术前、术后Harris评分评价疗效并进行统计学分析。结果 1例失访，随访13例(14髋)，随访时间18～36个月，平均23个月。术前Harris评分(38.56±3.67)分，术后评分(85.43±2.89)分，术后髋关节功能明显改善，疼痛显著减轻。结论 髋臼重建及股骨转子下短缩横行截骨全髋置换术治疗CroweⅣ型成人DDH效果满意。
Abstract：Objective This study was designed to evluate the clinical efficacy of total hip arthroplasty(THA) with acetabular reconstruction and transverse subtrochanteric shortening osteotomy in adult Crowe Ⅳ DDH in plateau.Methods Crowe Ⅳ type DDH adult patients 15 hips including 4 male patients (4 hips) and 10 females (11 hips)，with average age at (36±8) years old (range from 23 to 56 years)，underwent acetabular reconstruction and transverse subtrochanteric shortening osteotomy during THA from May 2009 to May 2013.Biological acetabular cup and S-ROM femoral prosthesis with ceramic-ceramic interface was used and preoperative and postoperative Harris score were assessed for evaluating the efficacy and analyzed statistically.Results 13 cases (14 hips) were followed up (except one case was lost) for 23 months averagely (range 18～36 months).Preoperative and postoperative Harris score was (38.56±3.67) and (85.43±2.89) points respectively.Postoperative hip joint function was significantly improved and pain reduced.Conclusion It is safe and effective to perform THA with acetabular reconstruction and transverse subtrochanteric shortening osteotomy in Crowe type Ⅳ adult DDH patients.
张小兆，逯登鹏，刘曦，王东，钟生财. 全髋关节置换术治疗Crowe Ⅳ型成人发育性髋关节发育不良[J]. 实用骨科杂志, 2017, 23(3): 252-256.
Zhang Xiaozhao，Lu Dengpeng，Liu Xi，et al. Clinical Effect of Total Hip Arthroplasty for Adult Crowe Type Ⅳ Developmental Dysplasia of the Hip. sygkzz, 2017, 23(3): 252-256.
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