CAJ | 학술논문

目的：探讨股骨矢状位劈开固定股骨假体在全髋关节置换治疗成人髋关节发育不良（ CroweⅣ型）患者术后的疗效分析。方法2002年3月～2012年11月，本组在全髋关节置换术中以股骨矢状位劈开固定股骨侧假体治疗重度成人髋臼发育不良（ Crowe Ⅳ型）患者共21例24髋，股骨上移4.5～6.9 cm，平均（4.53±0.89） cm。术前Harris 评分（38.21±3.09）。结果21例（24髋）患者获随访，截骨端均骨性愈合，平均愈合时间3.8个月；术后6个月Harris评分（85.73±4.15）分，与术前比较差异有统计学意义（t＝-104.2，P＜0.05）。随访期间均无感染、脱位、假体翻修等并发症出现。结论股骨矢状位劈开固定股骨假体在全髋关节置换治疗成人髋关节发育不良（ CroweⅣ型）患者的手术效果稳定，手术技术具有可重复性，能够获得满意的疗效，可在临床中广泛推广。
목적：탐토고골시상위벽개고정고골가체재전관관절치환치료성인관관절발육불량（ CroweⅣ형）환자술후적료효분석。방법2002년3월～2012년11월，본조재전관관절치환술중이고골시상위벽개고정고골측가체치료중도성인관구발육불량（ Crowe Ⅳ형）환자공21례24관，고골상이4.5～6.9 cm，평균（4.53±0.89） cm。술전Harris 평분（38.21±3.09）。결과21례（24관）환자획수방，절골단균골성유합，평균유합시간3.8개월；술후6개월Harris평분（85.73±4.15）분，여술전비교차이유통계학의의（t＝-104.2，P＜0.05）。수방기간균무감염、탈위、가체번수등병발증출현。결론고골시상위벽개고정고골가체재전관관절치환치료성인관관절발육불량（ CroweⅣ형）환자적수술효과은정，수술기술구유가중복성，능구획득만의적료효，가재림상중엄범추엄。
Objective To investigate the therapeutic effects of the femoral splitting fixation of the femoral prosthesis at the sagittal plain in the total hip arthroplasty ( THA) for the treatment of the adult patients with Crowe typeⅣdevelopmental dysplasia of the hip.Methods From March 2002 to October 2012, 21 patients (24 hips) with severe Crowe typeⅣdevelopmental dysplasia of the hip underwent THA by the femoral splitting fixation of the femoral prosthesis at the sagittal plain.The femoral displacement was (4.5-6.9) cm upward, and the average was (4.53 ±0.89) cm.The preoperative Harris score was (38.21 ±3.09).Results All patients were followed up.All the fractures united and healed with the mean time of 3.8 months.The Harris score was (85.73 ±4.15) in the six months after the operation;comparing with the preoperative score, the difference in the Harris score was significant (t=-104.2, P<0.05) .No infection, dislocation, revision of the prosthesis and other complications were observed during the follow-up.Conclusion The operation of femoral splitting fixation of the femoral prosthesis at the sagittal plain in THA for Crowe type Ⅳ developmental dysplasia of hip in adults, turns out a stable and repeatable technique.It can obtain satisfactory results and be widely applied in clinic.