股骨近端Z形短缩截骨全髋置换术治疗成人CroweⅣ型发育性髋关节脱位

目的 探讨股骨近端Z形短缩截骨全髋置换术治疗CroweⅣ型成人髋关节发育不良的手术方法和临床疗效.方法 2000年7月至2006年2月,对13例CroweⅣ型成人发育性髋关节脱位继发骨关节炎患者行全髋关节置换术,同时采用股骨近端Z形短缩截骨.回顾性分析13例患者的临床资料,其中左髋9例,右髋4例.术前Harris评分36.9分.结果 所有患者均获得随访,随访时间4～55个月,平均32个月.Harris评分术后增加至84.1分.患者均能自行下地行走,步态明显改善,髋关节功能良好.结论 股骨近端Z形短缩截骨及全髋关节置换术是治疗Crowe Ⅳ型成人髋关节发育不良继发骨关节炎的有效方法,但手术难度大.其后期疗效有待进一步随访观察.

The methods of shorting proximal femoral and total hip arthroplasy for Crowe Ⅳ dysplastic hip of adults

Objectives To discuss the methods and outcome of shorting proximal femoral and total hip arthroplasy for Crowe Ⅳ dysplastie hip of adults. Methods From July 2000 to February 2006,13 cases of osteoarthritis secondary to severe development dysplastic hip were treated by total hip replacement and the shorting proximal femoral.Results The duration of follow-up ranged from 4 months to 55 months. The average score inereased from 36.9 to 84.1 points after the surgery according to Harris.All the patients could walk independently.Their paces were improved obviously and the function of their hips was satisfactory.Conclusions The treatment bv total hip arthroplasy and the shorting of posterior femoral is effective and efficient for osteoarthritis secondary to Crowe Ⅳ development dysplastic hip in adults. The long-term followup is necessary for further study.