【摘要】 目的:探讨年龄、性别、脱位侧别、脱位程度、石膏固定体位、内收肌切断与否、术前股骨头骨化核出现与否与要幼儿髋关节发育不良股骨头坏死之间的关系。方法:82例(90髋)髋关节发育不良采用闭合复位,术前均行过头皮牵引,全麻下进行复位,其中51髋术前行内收肌切断术,67髋复位后用改良蛙式石膏固定,23髋复位后用人体位石膏固定,固定时间6-9个月。结果:82例平均随访8年2个月,股骨头坏死发生率为33.3%,其中复位时年龄为12～24个月龄39髋中12髋(30.8%)发生股骨头坏死,24-36个月龄的33髋中18髋(54.5%)发生股骨头坏死,Ⅰ°脱位20髋未发生坏死,Ⅱ°脱位51髋中12髋(23.5%)发生股骨头坏死,Ⅲ°脱位19髋中18髋(94.7%)发生股骨头坏死。结论:股骨头坏死与髋脱位程度、诊治时年龄、骨化核出现与否有密切相关,其中与脱位程度相关最密切,其次是诊治年龄,而后为骨化核的出现。更多还原

【Abstract】 Objective: To study the main causes of the avascular necrosis following closed reduction of the developmental dysplasia of the hip (DDH) in order to improve clinical results and find an ideal measure for improving the treatment efficacy. Mothods: Eighty-two patients with ninety cases with DDH in which avascular necrosis (AVN) developed after closed reduction were followed-up for an average of 8 years from the time of reduction. Medical records and radiographs of all patients with DDH undergone a closed reduction were examined retrospectively. The incidence and concequences of AVN were recorded. Radiographs were scrutinized to identify the signs of AVN described by Salter. Results: All of the hip, 30(33. 3%) had some evidence of avascular necrosis. Conclusion: The incidence of AVN following closed reduction of DDH was highly associated with degree of preoperative displacement, the age at the time of reduction and the presence of delay of the ossific center.更多还原