目的:与自体髂骨加股骨移植比较,评价骨盆联合股骨近端截骨术中应用同种异体骨加自体股骨混 合骨移植治疗发育性髋关节脱位的临床疗效。 方法:对2004-10~2006-10间有完整资料的51例(68髋)发育 性髋关节脱位患儿进行回顾性分析。 A组(自体髂骨加股骨移植组)17例(25髋),术前年龄(5.28依3.37)岁, T觟nnis分级域毅3髋,芋毅4髋,郁毅18髋;B组(同种异体骨加自体股骨混合移植组)34例(43髋),术前年龄(4.19依 2.23)岁,T觟nnis分级域毅7髋,芋毅10髋,郁毅26髋。 两组均采用骨盆Pemberton截骨联合股骨近端转子下短缩、内 翻、旋转截骨术。 结果:术后平均随访(6.10依1.32)a,两组骨性髋臼指数、CE角以及Reimers 指数改善明显。 Mckay标准评定髋关节功能,A组优良率88.00%,B组83.72%;Severin标准评定X线表现,A组优良率76.00%, B组74.42%;Eck标准评定植骨融合,A组满意率92.00%,B组90.70%,两组比较无差异(分别字 2 =0.001,P= 1.000;字 2 =0.021,P=0.885;字 2 =0.033,P=1.000)。 影像学证实,B组植骨融合时间长于A组(t=2.973,P= 0.005)。 结论:发育性髋关节脱位联合截骨术中应用同种异体骨加自体股骨混合移植与自体髂骨加股骨移植有 相似的临床效果,可以弥补自体骨量不足的缺陷。

Objective:To evaluate the clinical effects of autologous iliac affiliate femoral graft, comparedwithallogeneicboneaffiliateautologous femoral mixedgraft indevelopmental dysplasiaof the hip(DDH)treated with acetabular and proximal femora derotation osteotomy. Methods:Between October 2004andOctober 2006,thecompletedataof 51children(68hips)of DDHwere treatedwith groupA(autologous iliacaffiliatefemoral graft group)andgroupB(allogeneicboneaffiliateautologous femoral mixed graft group)at hospital. Group Ahad 17 children(25 hips),according to T觟nnis classification,3 hips,4 hips and 18 hips were graded as域毅,芋毅and 郁毅respectively. Before theoperation,the average age was 5. 28 依3. 37years. GroupBhad34children(43hips),according to T觟nnis classification,7 hips,10 hips and26 hips were graded as域毅,芋毅and 郁毅respectively. The averageagewas4. 19依2. 23years. Theclinical outcomeof DDHtreatedwithPembertonacetabular os鄄 teotomyandproximal femoral subtrochantericshorteningandvarus derotationosteotomy. All cases were followedupfor averagetimeof 6. 10依1. 32years. Bony acetabular index andcenter-edge angle(CE angle)andthe Reimers index were significantly improvedbefore surgery andpostoperative. The good rateof hip function was 88. 00%in group Aand83. 72%in group Bthat according to the Mckay clinical criteriatoassessment of hipfunction. Thegoodrateof imageologywas76. 00%ingroupAand 74. 42%ingroupBthat according to Severinradiographic classification. The satisfactionrate of graft fusionwas 92. 00%ingroupAand90. 70%ingroupBthat accordingtoEckclassification. Therewere nosignificant differencebetweentwogroups(字 2 =0. 001,P=1. 000;字 2 =0. 021,P=0. 885;字 2 =0. 033, P=1. 000respectively). Theimaging confirmedthat bone fusiontime ingroupBwas longer thanthe groupA,thedifferencewas statisticallysignificant(t=2. 973,P=0. 005). Conclusion:Allogeneicbone affiliateautologous femoral mixedgraft inDDHosteotomy was aneffective method,whichwas similar withautologous iliacaffiliatefemoral graft clinical effect andcouldmakeupfor thelackof quantityof autologous bonedefects.

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