王继孟 杨吉义 陈新国 王恒冰 王延宙 250021 济南， 山东省立医院小儿外科 中华小儿外科杂志 1998 0 19 4


    关键词：髋脱位；先天性；髋臼；骨膜；移植 期刊 zhxrwkzz 0 临床研究 fur -->


    

摘要 目的:应用带骨膜及软骨的髂骨移植髋臼成形术， 治疗先天性髋关节脱位(CDH)，对移植骨块的生存、转归及疗效作评价。 方法： 在真臼上缘缺损处，向内上方凿一深骨槽。 切取带有髂骨内板骨膜和软骨的全层骨块，嵌入骨槽中， 形成杯口状， 骨膜伸展贴附在髂骨外板上。 结果：本组68例(90髋)CDH， 69髋(76.7%)移植骨膜处有板状骨形成，连接骨块与髂骨。随访2年以上36髋， 优24髋(66.7%)， 良10髋(27.8%)， 差2髋(5.6%)，总优良率为94.5%。结论： 该术式显示移植的全层骨块成活迅速， 恢复期短而完全，并保持了不同期的生物强度； 游离的骨膜有较强的成骨活性；骨块的应力、 固定牢固等因素对移植骨的生存起重要作用。

    Acetabuloplasty to Treat Congenital Dislocation ofHip: Transplantation of Ilium Graft with Periosteum and Cartilage Wang Jimeng, Yang Jiyi, Chen Xinguo, et al. Provinvial Hospitalof Shandong, Jinan 250021

    Abstract Objective: Sixty-eight children (90 hips) with congenitaldislocation of hip (CDH) were treated by acetabuloplasty using ilium bony graft withintact periosteum and cartilage. The state of transplanted bone and outcome of theprocedure were evaluated. Methods: A bonygroove was made on the upper rim of the acetabulum, and extended medially and upward on the ilium. A piece of ilium including thecrest cartilage and the periosteum from endosteal lamella of ilium was taken off en-blocas a free bony graft. The bony part of the graft was inserted into the acetabular grooveto make a new upper lip of the socket. The rest of periosteum were stretched and stuckonto the outer lamella of ilium. Results: 36 hips were followed-up over 2 years. Excellentwas in 24 hips (66.7%), good in 10 (27.8%) and poor in 2. The total satisfactory rate was94.5%. Conclusions: Rapid graft surviving and healing with complete restoration offunction are the advantages of this procedure. The firm fixation with free periosteum ofthe graft provides good osteogenic activity. The stable graft with reasonable directionagainst the biologial stress are important factors to an early and perfect healing.

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