中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2008年
11期
678-681
,共4页
髋发育不良%先天性%股骨头缺血性坏死%闭合复位
髖髮育不良%先天性%股骨頭缺血性壞死%閉閤複位
관발육불량%선천성%고골두결혈성배사%폐합복위
Hip dysplasia,congenital%Avascular necrosis of femur head%Closed reduction
目的 研究闭合复位术治疗发育性髋脱位(DDH)的长期随访结果,评估导致股骨头缺血坏死(AVN)的相关因素.方法 对DDH闭合复位后81例(106髋)进行平均3.6年的随访,Kalamchi and MacEwen分级评定缺血坏死,总结临床记录和影像学资料,统计分析缺血坏死的相关因素.结果 106髋中39髋发生缺血坏死(36.8%).其中,股骨头骨化中心发育基本正常的59髋中,7髋发生缺血坏死(11.9%);骨化中心发育偏小的40髋中,27髋发生缺血坏死(67.5%);骨化中心延迟未出现的7髋中5髋发生缺血坏死(71.4%).脱位程度越高发生缺血坏死的风险越大(P＜0.05).其他因素:性别、复位年龄、石膏固定类型、内收肌合并髂腰肌切断与缺血坏死的发生均无显著统计学意义.结论 闭合复位治疗发育性髋脱位,股骨头骨化中心发育延迟和高脱位与股骨头缺血坏死的发生相关.
目的 研究閉閤複位術治療髮育性髖脫位(DDH)的長期隨訪結果,評估導緻股骨頭缺血壞死(AVN)的相關因素.方法 對DDH閉閤複位後81例(106髖)進行平均3.6年的隨訪,Kalamchi and MacEwen分級評定缺血壞死,總結臨床記錄和影像學資料,統計分析缺血壞死的相關因素.結果 106髖中39髖髮生缺血壞死(36.8%).其中,股骨頭骨化中心髮育基本正常的59髖中,7髖髮生缺血壞死(11.9%);骨化中心髮育偏小的40髖中,27髖髮生缺血壞死(67.5%);骨化中心延遲未齣現的7髖中5髖髮生缺血壞死(71.4%).脫位程度越高髮生缺血壞死的風險越大(P＜0.05).其他因素:性彆、複位年齡、石膏固定類型、內收肌閤併髂腰肌切斷與缺血壞死的髮生均無顯著統計學意義.結論 閉閤複位治療髮育性髖脫位,股骨頭骨化中心髮育延遲和高脫位與股骨頭缺血壞死的髮生相關.
목적 연구폐합복위술치료발육성관탈위(DDH)적장기수방결과,평고도치고골두결혈배사(AVN)적상관인소.방법 대DDH폐합복위후81례(106관)진행평균3.6년적수방,Kalamchi and MacEwen분급평정결혈배사,총결림상기록화영상학자료,통계분석결혈배사적상관인소.결과 106관중39관발생결혈배사(36.8%).기중,고골두골화중심발육기본정상적59관중,7관발생결혈배사(11.9%);골화중심발육편소적40관중,27관발생결혈배사(67.5%);골화중심연지미출현적7관중5관발생결혈배사(71.4%).탈위정도월고발생결혈배사적풍험월대(P＜0.05).기타인소:성별、복위년령、석고고정류형、내수기합병가요기절단여결혈배사적발생균무현저통계학의의.결론 폐합복위치료발육성관탈위,고골두골화중심발육연지화고탈위여고골두결혈배사적발생상관.
Objective To reviewed the closed reduction for Developmental Dysplasia of the Hip (DDH),and analyzed the causative factors of avaseular necrosis(AVN).Methods We reviewed the results of closed reduction for DDH in 81 children(106 hips)over 3.6 year period.AVN was diag-nosed according to the criteria of Kalamchi and MaeEwen.The possible causative factors from medical records and radiographs were analysized.Results 39 out of 106 hips(37%)developed AVN.When the ossific nucleus was nornal in size,for the age,11.9%(7/59)developed AVN.When the nucleus was smalI for age as compared to the opposite side 67.5%(27/40)developed AVN and 71.4%(5/7)of delayed nucleus formation developted AVN.The incidenee of AVN increased with the grade of the dislocation.Other factors such as gender,age at reduction,plaster mode,adductor tenotomy were not statistically significant.Conclusions Delayed nucleus formation or nueleus developmental dysplasia and high dislocation are the risk factors of AVN in closed reduction for DDH.
