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目的:探讨应用两种股骨截骨旋转角度测量方法矫正股骨颈前倾角(FNA)在儿童发育性髋关节脱位(DDH)治疗中的价值。方法:回顾性分析我科自2006年1月~2015年6月行手术治疗的DDH 32例(32髋),其中,股骨旋转截骨时,2006年1月~2009年12月的16例(16髋)采用画线法;2010年1月~2015年6月的16例(16髋)采用量角法。术前及术后进行X线及三维CT检查测量FNA。两组的一般资料及术前健侧及患侧FNA角度的差异无统计学意义(P>0.05)。结果:本组病例均获得随访,随访时间12~48个月,平均28个月。两组术后患侧FNA与术前相比,均差异明显(P<0.01);而与健侧相比,差异不明显(P>0.05),说明术后FNA较术前明显改善,达到与健侧大致相等的FNA。两组间术后健侧、患侧FNA比较,无显著性差异(P>0.05),故,目前尚不足以证明行股骨旋转截骨术时后期采用的量角法优于画线法。结论:采用量角法及画线法进行股骨旋转截骨术均可获得满意疗效。
Objective: To investigate the value of using two methods of femoral osteotomy to correct the femoral neck anteversion (FNA) in the treatment of children with developmental dislocation of the hip (DDH). Methods: 32 cases (32 hips) of DDH treated surgically from January 2006 to June 2015 were retrospectively analyzed. Among them, 16 cases (32 hips) of DDH during osteotomy of femur during January 2006 to December 2009 16 hips) were drawn using the line drawing method. From January 2010 to June 2015, 16 patients (16 hips) were measured by the angle method. Preoperative and postoperative X-ray and three-dimensional CT examination FNA. There was no significant difference between the two groups in general information and preoperative anteroposterior and ipsilateral FNA angle (P> 0.05). Results: The patients were followed up for 12 to 48 months with an average of 28 months. Compared with the preoperative, the FNA of the affected side of the two groups was significantly different (P <0.01), but not significant difference compared with that of the contralateral side (P> 0.05), which indicated that the postoperative FNA was significantly improved compared with preoperative Approximately equal FNA. There was no significant difference (P> 0.05) between the two groups in the contralateral and contralateral FNA after operation, so it is not enough to prove that the angle-angle method adopted in the later period of femur rotation osteotomy is better than the line drawing method. CONCLUSION: Satisfactory curative effect can be obtained by using angle method and drawing line method for femoral osteotomy.