关键词: Dega osteotomy Kalamchi-MacEwen classification Kellgren-Lawrence classification avascular necrosis of the femoral head developmental dysplasia of the hip osteoarthritis

来  源:   DOI:10.1302/1863-2548.15.210006   PDF(Pubmed)

Abstract:
UNASSIGNED: Late-diagnosed dislocated hips underwent open reduction, Dega osteotomy, and proximal femoral osteotomy between 1968 and 1988. The objectives of this study are to assess the survival of hips into adulthood, clinical and radiological outcome, patients\' life perspectives and the risk factors of failure.
UNASSIGNED: An assessment of 67 hips treated when younger than five years (UNASSIGNED: The 40-year survival rates were 73% (95% confidence (CI) 71% to 76%) in the UNASSIGNED: Early failure risk factors are older age at the surgical procedure, high AVN grade and bilateral hip involvement. Still, the results facilitate hip reposition whenever technically manageable, even in teenagers.
UNASSIGNED: III.
摘要:
晚期诊断的髋关节脱位进行了切开复位,Dega截骨术,和股骨近端截骨术在1968年至1988年之间。这项研究的目的是评估臀部成年期的存活率,临床和放射学结果,患者的生活观和失败的危险因素。
对小于5岁时治疗的67髋的评估(<5岁。组)和该组中年龄在5岁以上(5岁以上)的71髋。)被执行。所有病例均进行了临床和影像学评估,并评估了生存率,将髋关节置换作为失败的终点(缩写HR+是指接受了髋关节置换手术的髋关节;HR-是指随访时尚未被置换的髋关节).计算了生育率和社会保障残疾福利(SSDB)接受者百分比。
在<5岁时,40年生存率为73%(95%置信度(CI)71%至76%)。group,54%(95%CI51%至57%)在+年龄5岁。group,单侧脱位占70%(95%CI67%至73%),双侧脱位占57%(95%CI54%至60%)。在后续行动中,Harris髋部和西安大略省和麦克马斯特大学骨关节炎评分中位数分别为90.0和13.0(<5岁。group,HR-),74.0和28.0(+年龄5岁。group,HR-),90.0和16.0(<5岁。group,HR+)和84.5和11.5(+年龄5岁。group,HR+),分别。该操作标准化了放射学参数。术后中位2.6年股骨头缺血性坏死(AVN)分级与随访时骨关节炎分级的相关性为0.38(p<0.001)。生育率为1.54。总的来说,16.0%(5岁以下)和38.5%(5岁以上)的患者接受SSDB(p=0.003)。
早期失败的危险因素是外科手术中年龄较大,高AVN分级和双侧髋关节受累。尽管如此,无论何时在技术上可管理,结果都有助于髋关节复位,即使是青少年。
III.
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