Objective To analyze and evaluate adult patients with congenital dislocation of the hip patients to the clinical efficacy of the implementation of total hip arthroplasty. Implementation of a total hip arthroplasty: 18 cases of Crowe, Ⅳ congenital dislocation of the hip patients, preoperative administration of skeletal traction for 2 weeks of treatment, intraoperative lysis and reconstruction of the hip center of rotation and hip abduction postoperatively Limb Lengthening the assessment of hip function. Results The average time of the surgery the patient was 100.5 ± 9.5min, hand bleeding volume average is (490.4±31.5)mL; joint center of rotation of all patients with reconstruction of the normal anatomical position. Followed up for 15 months after surgery the patient, and did not find the cup and the femoral prosthesis loosening, the Harris hip score was average (90.4±3.1); follow-up was not found during the dislocation, fracture, and periprosthetic tissue infections. Conclusion The Crowe, Ⅳ congenital dislocation of the hip in patients with tibial traction before surgery, the release of the hip center of rotation and re-establish a reasonable choice of the prosthesis, the effective protection of the nerves and blood vessels and other measures, the use of artificial hip arthroplasty surgery can still achieve a better therapeutic effect.% 目的 分析并评价成人先天性髋关节脱位患者实施人工全髋关节置换术的临床疗效.方法 对18例 Crowe Ⅳ型先天性髋关节脱位患者实施人工全髋关节置换术,术前给予骨牵引治疗2周,术中松解与重建髋关节旋转中心以及髋关节外展功能,术后对肢体延长情况与髋关节功能进行评估.结果 该组患者手术平均用时为(100.5±9.5)min,手术中出血量平均为(490.4±31.5)mL；所有患者的关节旋转中心重建在正常解剖位置.术后对患者进行15个月的跟踪随访,没有发现臼杯与股骨假体松动情况,Harris 评分结果为平均(90.4±3.1)分；随访期间未发现关节脱位、骨折和假体周围组织感染病例.结论 对 Crowe Ⅳ型先天性髋关节脱位患者实施手术前胫骨牵引、对髋关节旋转中心的松解和重新建立、对假体的合理选择、对神经血管的有效保护等措施,采用人工髋关节置换术的手术效果还是可以取得较好的治疗效果.
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