摘要目的 探讨髋臼加深内移结合粗隆下横形截骨全髋关节置换术(total hip arthroplasty,THA)治疗成人Crowe Ⅳ型髋关节发育不良(developmental dysplasia of the hip,DDH)的有效性。方法 本组5例6髋,均为女性;平均年龄56岁(46~65岁);单侧4例,双侧1例;均为Crowe Ⅳ型DDH继发骨关节炎,因关节疼痛伴功能障碍而接受手术者;既往均无手术史及其他关节病史,均采用捷迈全骨小梁锥形翻修假体结合髋臼加深内移和股骨粗隆下横断截骨短缩行THA。术前Harris髋关节评分为41分。结果 本组5例6髋均获随访,随访时间9~36个月,平均18个月。患髋X线片显示所有股骨粗隆下截骨均获愈合,平均愈合时间为4个月。脊柱代偿性侧弯均有恢复。患者疼痛均消失,假体位置良好,患者对术后功能均满意,跛行均随着时间延长好转,有2例患者仍有轻度跛行。术后评分为89分,其中优3例,良1例,中1例。平均屈髋活动度术前为110°,术后为99.20°。本组无一例出现关节感染、假体松动及脱位、神经功能损伤等并发症。术后肢体延长平均4 cm,肢体短缩纠正满意。结论 髋臼加深内移结合粗隆下横形截骨,合理控制臀中肌张力,有利于髋关节周围软组织平衡,是一种安全、有效的手术方法。
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