股骨短缩截骨全髋置换术治疗青年Crowe Ⅳ型髋关节发育不良.

Objective: To analyze and summarize the short-term efficacy of total hip arthroplasty with femoral shortening in treatment of youth Crowe type IV developmental hip dysplasia(DDH). Methods: From January 2009 to January 2015,22 young patients(24hips)with Crowe type Ⅳ DDH were treated by total hip arthroplasty with femoral shortening. There were 4 males(5 hips) and 18 females(19 hips), with an average age of 22 years(range, 17 to 27 years).A visual analog scale(VAS) evaluated the hip pain, Harris hip score evaluated the hip joint function and the leg discrepancy were recorded before and after the operation. The clinical and radiological results of these patients were collected. Results: Patients were followed up for an average of 38 months(range 6 to 72 months). The healing time of fracture was an average of 3.2 months( range 3 to 6 months). The Harris score was improved from(43.2±2.7)preoperatively to(95.3±2.8)postoperatively, showing significant difference(P<0.01). The VAS score was improved significantly after the operation(P<0.05) from(6. 0±1. 0) to(1. 0 ±0.5). The leg discrepancy was(16.5±5.5)mm after operation, showing significant difference when compared with the one(55.5±15.5)mm before the operation(P<0.01). After surgery, 6 cases had mild claudication.Besides,2 cases had sciatic nerve palsy but which resolved completely in 6 months. There was no biocompatibility between the materials and the hosts, and no revision of acetabular and femoral prostheses was performed during follow-up. Conclusions: The total hip arthroplasty with femoral shortening osteotomy can receive satisfied short-term effect in treatment of adolescent Crowe type Ⅳ developmental dysplasia of the hip.Taking into consideration various factors, including the degree of release of the soft tissue and the way and length of femoral shortening osteotomy, can reduce the leg discrepancy effectively, avoid damaging the vessels and nerves and improve the function of hip-joint. [ABSTRACT FROM AUTHOR]