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• W4200439709 abstract "To investigate the effectiveness of sliding trochanteric osteotomy (STO) in total hip arthroplasty (THA) for Crowe type Ⅳ developmental dysplasia of the hip (DDH).Between July 2016 and April 2021, 52 patients (57 hips) with Crowe type Ⅳ DDH who underwent primary THA were enrolled according to inclusion criteria. There were 5 males and 47 females with a median age of 51 years (range, 18-76 years). There were 47 cases of single hip and 5 cases of bilateral hips. The leg length discrepancy (LLD) was 50.50 (44.00, 55.00) mm, visual analogue scale (VAS) score was 8.0 (6.0, 9.0), and Harris score was 58.0±5.0 before operation. Trendelenburg sign was positive in 46 patients (46 hips). All patients underwent STO and THA using Wagner-cone stem. The operation time, intraoperative blood loss, blood transfusion volume, Trendelenburg sign, and related complications were observed. During follow-up, VAS and Harris scores were recorded to evaluate the hip pain and function. X-ray film was used to measure the LLD and observe the bone union situations.The operation time was 90-125 minutes (mean, 105 minutes). Introperative blood loss was 420-800 mL (mean, 640 mL). Ten patients underwent blood transfusion and the amount of allogeneic blood transfusion was 2-4 U (mean, 3 U). All incisions healed by first intention after operation. All patients were followed up 4-60 months (median, 24 months). At last follow-up, LLD was 6.00 (4.00, 7.75) mm, showing significant difference when compared with that before operation ( Z=-6.278, P=0.000). After operation, 51 hips (89.5%) achieved bone union at the osteotomy site, 4 hips (7.0%) had fibrous union, and 2 hips (3.5%) had nonunion. The healing time of osteotomy was 3-12 months, with an average of 6 months. At last follow-up, the VAS score was 3.0 (2.0, 5.0) and the Harris score was 85.0±6.0. The differences between pre- and post-operation were significant ( Z=-6.176, P=0.000; t=-25.285, P=0.000). Trendelenburg sign remained positive in 4 patients (4 hips) at last follow-up and the difference was significant when compared with preoperative ( χ2=67.947, P=0.000). One patient had a medial femoral cortical fracture when Wagner-cone stem was implanted during operation, and 2 patients had early symptoms of sciatic nerve palsy after operation, and no other related complications occurred.For Crowe type Ⅳ DDH patients, STO applied in THA can reduce the resected bone mass, provide better exposure of hip as well as improve function of hip abductor muscle. Wagner-cone stem is recommended.探讨人工全髋关节置换术（total hip arthroplasty，THA）治疗Crowe Ⅳ型发育性髋关节发育不良（developmental dysplasia of the hip，DDH）术中，使用股骨大转子滑移截骨术（sliding trochanteric osteotomy，STO）的疗效。.回顾分析2016年7月—2021年4月收治且符合选择标准的52例（57髋）Crowe Ⅳ型 DDH患者临床资料。男5例，女47例；年龄18～76岁，中位年龄51岁。单髋47例，双髋5例。术前双下肢长度差值（leg length discrepancy，LLD）为50.50（44.00，55.00）mm，疼痛视觉模拟评分（VAS）为8.0（6.0，9.0）分，Harris评分为（58.0±5.0）分。46例（46髋）Trendelenburg征阳性。患者均采用Wagner-cone股骨柄行THA，术中行STO。记录手术时间以及术中失血量、输血量，观察Trendelenburg征以及相关并发症发生情况。随访期间采用VAS评分及Harris评分评价髋关节疼痛及功能恢复情况，复查X线片测量LLD并观察截骨愈合情况。.手术时间90～125 min，平均105 min。术中失血量为420～800 mL，平均640 mL；10例进行输血，同种异体输血量2～4 U，平均3 U。术后切口均Ⅰ期愈合。患者均获随访，随访时间4～60个月，中位时间24个月。末次随访时LLD为6.00（4.00，7.75）mm，与术前比较差异有统计学意义（ Z=−6.278， P=0.000）。51髋（89.5%）截骨部位达骨性愈合，4髋（7.0%）纤维性愈合，2髋（3.5%）骨不连。截骨愈合时间3～12个月，平均6个月。末次随访时，VAS评分为3.0（2.0，5.0）分，Harris评分为（85.0±6.0）分，与术前比较差异有统计学意义（ Z=−6.176， P=0.000； t=−25.285， P=0.000）。4例（4髋）Trendelenburg征阳性，与术前比较差异有统计学意义（ χ2=67.947， P=0.000）。1例术中植入Wagner-cone股骨柄时发生股骨内侧皮质骨折，2例术后出现坐骨神经麻痹早期症状，无其他相关并发症发生。.Crowe Ⅳ型 DDH患者THA术中应用STO可以减少截骨量，充分暴露髋关节，更好地调节髋外展肌功能，同时宜选择Wagner-cone股骨柄。." @default.
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• W4200439709 date "2021-12-15" @default.
• W4200439709 modified "2023-09-27" @default.
• W4200439709 title "[Application of sliding trochanteric osteotomy in total hip arthroplasty for Crowe type Ⅳ developmental dysplasia of the hip]." @default.
• W4200439709 doi "https://doi.org/10.7507/1002-1892.202108125" @default.
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