Objective To study the clinical results of subtrochanteric osteotomy and total hip arthropasty for developmental dysplasia of the hip.M ethods 18 cases (23 hips) was treated at the First Affiliated Hospital of Soochow University between Aug. 2005and Dec. 2007. 16 hips were Crowegrdae 3. 7 hips were Crowegrdae 4. Average patient age was 52. 4 years(41~ 67 years). Average follow-up was 4. 5 years (3~ 6 years). All the patient unduent subtroc hanterictransverse osteotomy and total hip arthropasty. Cable fixation was used in osteotomy site in some cases ,and in the other cases the osteotomy site was filled with autogenous cancellous bone. Anterior-posterior and lateral radiographs of the hip were taken to observe preoperative and postoperative clinical results ,X-ray films of prosthesis were evaluated. Results The Harris hip scores improved from 43. 2 preoperatively to 90. 7 postoperatively at last follow-up. All femoral components and cups showed radiographic signs of bony ingrowth without radiolucencies or migration of components at last follow-up. Union of osteotomy site was achieved within an average of 3. 2 (range 2~ 6) months in all cases. There were no dislocations ,infections ,neurologic symptoms ,deep venous thromboses , or pulmonary embolism. Conclusion This technique allows correction of anteversion,provides excellent rotational stability and avoid neurologic injury in process of reducation. The clinical results are saticfactory.%目的 探讨全髋置换加转子下截骨治疗髋关节发育不良的疗效.方法 回顾性分析2005年4月至2007年12月我院收治的18 例(23髋)髋关节发育不良患者,男性6 例(6髋),女性12 例(17髋),CroweⅢ型16髋,CroweⅣ型7髋,平均年龄52.4 岁(41～67 岁),随访时间3～6年,平均4.5年.采用全髋置换术加转子下横行截骨,部分病例截骨处用钢丝捆扎固定,其他病例截骨处自体松质骨骨泥填充,评估术前术后的临床效果和假体影像学表现.结果 Harris评分由术前平均43.2分提高至最近一次随访时的平均90.7分,最近一次随访示:所有假体都骨性长入稳定,截骨处平均3.2个月(2～6个月)后愈合,无一例发生脱位、感染、神经症状、深静脉血栓的形成和肺栓塞.结论 全髋置换加转子下截骨可以纠正增大的前倾角,提供假体良好的抗旋转稳定性和避免复位时引起的神经损伤,临床疗效满意.
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