全髋关节置换术在成人晚期先天性髋关节脱位治疗中的应用

目的:研究全髋关节置换术治疗成人晚期先天性髋关节脱位的方法。方法:1997年4月~2000年4月,16例18髋成人晚期先天性髋关节脱位的患者接受了全髋关节置换手术,其中单侧14例,双侧2例。假体类型:非骨水泥型10髋、混合型6髋、骨水泥型2髋。随访时间平均3.8 a(3.2~4.6a)。结果:术后伤口均一期愈合。无血管及神经并发症出现。11髋术后肢体恢复等长,其余7髋较健侧缩短,但均小于5mm。平均H arris评分由术前52分增至术后92分。随访期未发现假体松动及脱位。结论:全髋关节置换术治疗成人晚期先天性髋关节脱位的手术比较复杂、并发症多,术前应有周密的计划,术中特别需要考虑肢体长度的均衡、假体的选择、髋臼骨床的制备及安置。

Application of the total hip replacement in the treatment of congenital dislocation of hip in late phase in adult patients

Objective:To study the application of the total hip replacement(THR) in the treatment of congenital dislocation of hip(CDH) in late phase in adult patients.Methods:From April 1997 to April 2000,18 hips from 16 adult patients diagnosed as CDH were treated with THR in our hospital,including 10 hips of cementless type,6 hips of hybrib type and 2 hips of cement type.The follow-up term was from 3.2 years to 4.6 years,with a mean term of 3.8 years.Results:The incision wound healed smoothly.There was no complication related to the nerve and vasculature.Of the 18 hips,11 totally recovered with the same leg length as the paired healthy hips,and the remaining 7 hips were shorter than the paired healthy ones in less than 5 mm.The average Harrs score increased from 52 before the operation to 92 points after the surgery.Neither loosening nor dislocation of the prostheses occurred in the time of follow-up.Conclusion :The THR treatment of patients with CDH could be complicated with some complication.The careful preoperative planning is recommended,during the operation,make sure to equalize the length of bilateral lower extremity,to balance the abductor muscles,to totally release the soft tissue,and to select the right components.