【摘要】 回顾性分析成人发育性髋关节脱位患者的生物型全髋关节置换手术方法及手术疗效。[方法]对1997年12月~2006年10月间接受生物型全髋关节置换术的61例(77髋)进行随访。其中女53例,男8例;年龄17~56岁,平均31.4岁。采用Hartofilakidis分型:I型15例(18髋),Ⅱ型23例(30髋),Ⅲ型23例(29髋)。术前Harris评分16~61分,平均为40分。手术入路采用后外侧入路,臼杯置于或接近于真臼水平。经关节囊切除,必要时松解髂腰肌,大多数病例插入股骨假体后均能顺利复位。但在Ⅲ型脱位中,有12例股骨头脱位高于真臼5 cm以上,经软组织松解后,仍无法拉下复位。故采用小转子下短缩截骨复位,截骨长度2~5 cm。所有病例术中臀中肌均保持完整,未切断或延长。术前未做牵引。[结果]结果随访时间12~118个月,平均49个月,术后Harris评分82~95分,平均为91分,术后并发症为股神经麻痹(1例),所有施行臼侧植骨及股骨截骨的病例植骨及截骨处均骨性愈合,无假体松动。活动度无明显受限,患髋无痛,Trendelenburg征阴性,均不使用行走辅助工具。[结论]成人发育性髋关节脱位尤其是高位脱位的生物型全髋关节置换术难度较大,但对此类患者是一种较为理想的 [2] Fumes O, Lie SA, Espehaug B, et al. Hip disease and the prognosis of total hip replacements, a review of 53 968 primary total hip replacements reported to the Norwegian arthroplasty register 1987-99[J].J Bone Joint Surg (Br) , 2001,83:579-586.
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