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改良Weissmen手术治疗严重骨盆倾斜 |
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吴其常 张志刚 王东生 苗旭漫
摘要 目的：脊髓灰质炎后遗严重骨盆倾斜，内收侧多伴有肢体短缩，持重功能丧失。传统手术，分期进行，周期长，疗效差。本研究的目的是探讨周期短，操作简单，疗效好的新术式。方法：采用改良Weissmen手术，即外展侧软组织松解加股骨转子下内收短缩截骨，内收侧利用对侧切取骨块做髂骨延长术。本组共21例，术前17例扶单拐，4例扶双拐。结果：术后平均随访3.8年，13例完全弃拐，5例短距离步行弃拐，3例扶单拐。结论：该术式具有一次矫正多种畸形的优点，缩短了治疗周期，提高了疗效，无术后严重并发症。
关键词 脊髓灰质炎后综合征 骨盆畸形
Modified Weissmen Operation for Severe Pelvic Obliquity Wu Qichang, Zhang Zhigang, Wang Dongsheng,et al. Military Hospital 208, Changchun 130062
Abstract Pelvic obliquity after poliomyelitis is usually caused by abduction contracture of the soft tissue around the unilateral hip .The adduction often led to limb shortening and lost of weight bearing function. Traditional operative treatment took a long period and required several stages, and the results were not completely satisfactory. Mordified Weissmen s procedure including adduction shortened osteotomy, soft tissue release on abduction limb and the bone stock taken from the opposite side used for ilium lengthening on adduction side. 21 patients have been treated by this method. The mean follow-up was 3.8 years. 13 were able to walk freely without support, 5 for short distance without support and 3 with single crutch. The authors considered that the procedures had an advantage for various deformities such as pelvic obliquity, shortened limb and poorly covered femoral head. The deformities could be corrected at one stage, and the treatment duration could be shortened. There was no major complications in this series.
Key words Poliomyelitis Pelvic abnormalities
骨盆倾斜可继发于下肢不等长、脊柱侧弯等畸形，但严重固定型骨盆倾斜多数由髋关节周围挛缩引起。该类畸形除软组织挛缩外，常伴有该侧颈干角增大，对侧髋臼发育不良或半脱位，肢体短缩以及脊柱侧弯等一系列改变。患者单肢负重，对侧足离地高悬，需扶单拐或双拐助行。既往常采用分期多次手术方法进行治疗。自1990年我们采用改良的Weissmen手术方法治疗21例，一次矫正多种畸形，收到满意效果。
临 床 资 料
本组男7例，女14例。年龄14～31岁，平均18.6岁。均为脊髓灰质炎后遗症。其中左髋挛缩9例，右侧12例。挛缩侧颈干角128°～147°，平均138.4°。其中17例大于130°。将测得的髋臼上缘连线与外展侧股骨轴线垂线的夹角称为骨盆倾斜角，本组为20°～31°，平均25.3°。 内收侧髋臼均显示发育不良，股[1] [2] 下一页
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