范 峥 李 岩 杨 礼 庆付勤

    (中国医科大学附属盛京医院脊柱关节外科，沈阳110004)

    短缩截骨下S-ROM假体联合真臼位关节成形在重度髋关节发育不良中的疗效评估

    范峥李岩杨礼庆付勤**

    (中国医科大学附属盛京医院脊柱关节外科，沈阳110004)

    背景：CroweⅣ型髋臼发育不良(DDH)存在严重解剖结构异常，全髋关节置换治疗中手术难度大，并发症发生率高。目的：探讨解剖位髋臼重建、S-ROM股骨假体联合转子下截骨对重度髋关节发育不良(DDH)的治疗效果。方法：2011年2月至2015年10月，采用S-ROM假体联合转子下截骨、真臼水平重建全髋关节置换术治疗15例(17髋)CroweⅣ型DDH。比较患者手术前后Harris评分、骨盆倾斜角、双下肢长度差、股骨颈/假体前倾角、髋臼/假体前倾角和联合前倾角的变化。结果：15例DDH患者平均随访(24.53±17.17)个月。Harris评分由术前(49±5.07)分增加至末次随访时的(81.36±11.91)分；术前患肢短缩(58.0±15.38)mm改善为随访时患肢延长(11.78±7.99)mm；骨盆倾斜角由术前3.06°±2.21°减小至随访时1.93°±1.83°；股骨颈前倾角由术前44.77°±11.68°减小至随访时25.25°±8.11°；髋臼前倾角由术前27.84°±9.19°变为随访时14.92°±2.69°；联合前倾角由术前71.81°±14.84°减小至随访时39.45°±7.26°。术后1例发生截骨处骨不愈合，随访时2例患者遗留轻度跛行，无假体松动、下沉及翻修病例。结论：短缩截骨下组配式S-ROM假体联合真臼位全髋关节置换术治疗CroweⅣ型DDH，预后良好。

    髋关节发育不良；S-ROM假体；转子下截骨；真臼重建

    【Abstract】Background：Due to distorted anatomy of Crowe typeⅣdevelopmental dysplasia of hip(DDH)，total hip arthroplasty(THA)in these patients represents technically demanding procedure and often gives rise to relatively high rate of complications.Objective：To investigate clinical efficacy of THA with S-ROM prosthesis and anatomic acetabular reconstruction as well as subtrochanteric osteotomy for CroweⅣdevelopmental dysplasia of hip(DDH).Methods：Fifteen(seventeen hips)patients with severe DDH(CroweⅣ)were treated by THA with S-ROM prosthesis and subtrochanteric osteotomy from February 2011 to October 2015.Harris hip score ......