摘要
发育性髋关节脱位(developmental dysplasia of the hip,DDH)是指髋关节结构及功能上的异常,其治疗目的在于恢复髋臼和股骨头的同心圆复位,保证其正常的生长发育。国内外对不同年龄段DDH患儿的治疗方式比较成熟,但对于18~24月龄DDH患儿的治疗方式选择存在较大争议,由于疾病预后以及手术创伤、费用、时长等因素影响着治疗方式的选择,因此至今尚没有明确的治疗方案。目前采用的手术方法主要包括闭合复位、单纯切开复位及骨盆截骨术,然而每种治疗方式下都有部分患儿存在严重并发症,如残余发育不良(residualacetabular dysplasia,RAD)和股骨头缺血性坏死(avascular necrosis,AVN)。由于DDH患儿术后并发症的影响因素复杂,且18~24月龄这一年龄段髋臼发育的特殊性,如何选择适合不同患儿的手术方法已成为当前临床治疗的难点。本文就18~24月龄DDH患儿的手术治疗研究进展进行综述,旨在为该年龄段患儿选择合适的手术方案提供参考依据。
Developmental dysplasia of the hip(DDH)refers to structural and functional abnormality of the hip.The objective is restoring concentric reduction of acetabulum and femoral head and enabling normal growth and development of the hip.At home and abroad,treatment of DDH children of different ages is relatively mature.However,there is an ongoing controversy over therapeutic options for DDH children aged(18-24)months.Outcomes,surgical traumas,costs and durations affect the options of treatment.Currently there is no definite therapeutic protocol.Major closed surgical procedures include reset,open reduction alone and pelvic osteotomy.During many follow-up studies,each option has such serious complications as residual acetabular dysplasia,ascular necrosis(RAD)and avascular necrosis(AVN)of femoral head.Due to complex factors affecting postoperative complications and a great specificity of acetabulum development at an age of(18-24)month,individualizing surgical approaches has become a clinical dilemma and a hot topic of recent researches.This review summarized the latest surgical researches for DDH children aged 18 to 24 months.The goal was to provide rationales for selecting appropriate surgical approaches.
作者
鲁婵
马娜
谢睿
陈新好
杨涵
康晓鹏
Lu Chan;Ma Na;Xie Rui;Chen Xinhao;Yang Han;Kang Xiaopeng(Department of Orthopedics,Municipal Children's Hospital,Kunming 650000,China)
出处
《临床小儿外科杂志》
CAS
CSCD
北大核心
2024年第5期489-492,共4页
Journal of Clinical Pediatric Surgery
基金
云南省杨军林专家工作站(202205AF150062)
关键词
发育性髋关节脱位
外科手术
儿童
Developmental Dislocation of The Hip
Surgical Procedures,Operative
Child
