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目的 :回顾性分析 1985年 1月～ 1995年 12月采用闭合复位治疗平均年龄 1.5岁先天性髋脱位 112例(144髋 )效果 ,探讨其影响因素。方法 :所有患儿均在全麻下行闭合复位 ,5 9例 78髋先行皮牵引 1～ 2周 ,5 3例 6 6髋先行内收肌切断再行手法复位 ,复位满意后行蛙式位或人体位石膏固定 ,不满意者改行手术治疗。复位后定期作 X线观察。结果 :获随访 92例 10 7髋 ,平均随访 6 .5年 ,优良率为 89%。获同心圆复位者 96髋 ,占 89.7% ,7例 11髋因复位不满意、髋臼发育不良而改行手术治疗。 3例 (5髋 )闭合复位后 2年有半脱位行手术治疗。股骨头坏死率为 7.5 %。结论 :闭合复位治疗先天性髋脱位要以患儿年龄及病理改变为基础 ,获得稳定的同心圆复位 ,才能提高疗效 ,降低并发症。
Objective: To retrospectively analyze the effect of closed reduction on the average age of 1.5 years old with congenital dislocation of hip (112 cases) (144 hips) from January 1985 to December 1995. Methods: All children underwent closed reduction under general anesthesia. 59 cases of 78 hips advanced traction for 1 to 2 weeks, 53 cases of 6 6 hips first adductor muscle cut off and then manual reduction, satisfied with the reset after the frog position or Gypsum fixed body, not satisfied with those who switch to surgery. After reset for X-ray observation. Results: A total of 92 patients (107 knees) were followed up for an average of 6.5 years. The excellent and good rate was 89%. 96 condyles were concentric reduction, accounting for 89.7%, 7 cases of 11 hips were not satisfied with the reduction, acetabular dysplasia and diverted to surgical treatment. Three patients (5 hips) had subluxation surgery 2 years after closed reduction. Femoral head necrosis was 7.5%. Conclusion: Closed reduction in treatment of congenital hip dislocation should be based on the age and pathological changes of children, to obtain a stable concentric reset in order to improve the efficacy and reduce complications.