成人脑瘫髋部骨性关节病的保关节手术。

E Nishioka, K Momota, N Shiba, F Higuchi, A Inoue
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引用次数: 3

摘要

背景:对12例成人脑瘫患者,15例髋关节骨关节病行保关节手术。方法:11髋只行Chiari骨盆截骨术;其中3髋行Chiari骨盆截骨联合股骨截骨术,另1髋仅行股内翻截骨术。术后平均随访6年2个月(随访2年3个月~ 10年6个月)。结果:15髋中有13髋疗效良好(86.6%)。2例行Chiari骨盆截骨术的弛缓性四肢瘫患者出现骨盆倾斜。在一例行Chiari骨盆截骨术的患者中,双侧髋关节继续发生进行性骨关节改变。结论:我们证实,如果对痉挛性麻痹的并发症给予足够的重视,通常的髋关节骨关节病治疗也适用于成人脑瘫患者的髋关节骨关节病。
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Joint-preserving operation for osteoarthrosis of the hip in adult cerebral palsy.

Background: A joint-preserving operation was performed on 15 hips with osteoarthrosis, involving 12 patients who had adult cerebral palsy.

Methods: Eleven hips underwent Chiari pelvic osteotomy only; three hips underwent Chiari pelvic osteotomy with femoral osteotomy and the other one hip underwent femoral varus osteotomy only. The mean follow-up period after surgery was 6 years and 2 months (with follow-up range of 2 years and 3 months to 10 years and 6 months).

Results: Good results were achieved in 13 of the 15 hips (86.6%). Two patients with athetotic tetraplegia treated with Chiari pelvic osteotomy had pelvic obliquity. Progressive osteoarthrotic change continued in bilateral hips in one case treated with Chiari pelvic osteotomy.

Conclusion: We confirm that usual treatment for osteoarthrosis of the hip was also applicable for osteoarthrosis of the hip in cases of adult cerebral palsy, provided sufficient attention is given to the complications accompanying spastic paralysis.

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