摘要
目的：定量研究Salter截骨术及其改良术式术后髋臼向前及向外侧旋转角度的改变，为改良Salter截骨术应用于先天性髋脱位的临床治疗提供理论依据。
方法：国人尸体脊柱及骨盆标本10具，拍正侧位X线片确定无骨盆疾病；Salter截骨法截断一侧髂骨，撑开截骨断端，分别用底边1.5、2.0、2.5cm的三角形木块填入截骨端，拍正侧位X线片。强力胶粘合截骨处；用我院改良Salter截骨法截断同侧髂骨，相同木块相同位置填入截骨端，拍正侧位X线片，测量各种条件下Sharp角旋转角度及髋臼向前旋转角度并进行统计学分析。
结果：两种截骨方法术后Sharp角均减小，髋臼向前旋转角度均增大，统计学上有显著差异(P＜0.05)。改良Salter截骨术与标准术式相比，髋臼向
－前旋转角度显著增大u＜0刀5）髓臼向外侧旋转角
度显著增大。u＜0刀5人
结论：S引盯截骨术及其改良术式应用于先天性
髓关节脱位手术治疗可使髓臼对股骨头的向前及向外
侧的覆盖面积增加，改良术式术后髓臼向前及向外侧
“旋转角度变化更大。因而可以更好地包容股骨头。
[Objective]:To quantity research acetabulum forward and outward rotation angle change of Salter osteotomy and improved Salter osteotomy,then to supply a theory basis for improved Salter osteotomy used on clinical cases.[Method]:To take 10 normal spinal and pelvis from Chinese cadaver. One side ilium was cut with Salter osteotomy,and the cut part was opened and insert a wooden block which were 1.5cm,2.0cm,2.5cm respectively,and to get their direct an lateral x-ray photogram,then some strong glue was put on osteotomy area for conglutination. And then cut the same ilium with improved Salter osteotomy,and used the same method above to manage the ilium. Finally,the Sharp angle and
acetabulum rotation angle were measured under the different conditions,then statistics analysis was done. [Results]:Sharp angle was decreased and acetabulum forward rotation angle increased in two kinds of osteotomy. The difference was significant (p<0.05). To composed improved Salter osteotomy with standard osteotomy,acetabulum forward rotation angle was increased significantly (p<0.05),acetabulum outward rotation angle was increased significantly (p<0.05). [Conclusion]:Both Salter osteotomy and improved Salter osteotomy for congenital hip joint dislocation can make acetabulum increase femoral head covered,the improved Salter osteotomy can make the angle change more significantly,so which can contain femoral head more sufficient.
引文
1 Salter R B. Innominate Osteotomy in the treatment of congenital dislocation and subluxation of hip.J Bone Joint Surg (Br),1961,43:581.
2 Chung JW, Ryan M, Obrien TM. Movement of the femoral head after Salter osteotomy for acetabular dysplasia. J Bone Surg (Br),1990,72:563-567.
3 Ponseti Ⅳ. Growth and development of the acetabulum in the normal child. Anotomical histological and roentgenographic studies. J Bone Joint Surg (Am), 1978,60:575-585.
4 刘强，耿景峰 吴晋普。改良Salter截骨治疗先天性髋脱位并发症分析及预防。中国矫形外科杂志，1997，4(6)：465。
5 姜世平，葛宝丰，张功林，等。改良Salter截骨治疗先天性髋关节脱位。中华骨科杂志，1995，15(2)：122。
6 刘卫东，吉士俊，周永德，等。改良Salter骨盆截骨术治疗先天性髋脱位疗效分析。中华骨科杂志，
1994，14(8)：470-473。
7 陈传功，梁栋，史史津，等。先天性髋脱位中股骨头坏死的预防与补救治疗。中国矫形外科杂志，1998，5(4)：300-301。
8 李晓光，张明。实用骨与关节X线测量。山东省科学技术出版社。1996，第1版：38。
9 陆裕朴，等。实用骨科学。人民军医出版社，1991：1238。
10 Schoenecker PL, Strecker WB. Congenital dislocation of the hip in children. J Bone Joint Surg (Am),1984,66:21.
11 Crenshaw AH, Campbell s operative orthopaedics.Vol 4,ed 7.Mosby, St louis, 1987,2725-2728.
12 彭明惺，胡廷泽，周锡华，等。各种髋臼重建术治疗先天性髋关节脱位的评价。中华小儿外科杂志，1985，3：136。
13 纪树荣，吉士俊，刘卫东，等。先天性髋脱位术后再发脱位的探讨。中华小儿外科杂志，1987，2：97。
14 Kalamchi All,et al. A vascular necrosis Following
treatment of congenital dislocation of the hip. J Bone Joint Surg (Am),1980,62:876.
15 李强一，王以进。骨盆截骨术治疗髋脱位的生物力学分析与临床应用。医用生物力学，2001，16 (1)：48-53。
16 Berkeley ME, Dicken JH, Cain TE, et al. Surgical therapy for congenital dislocation of the hip in patients who are twelve to thirty-six months old. J Bone Joint Surg(Am),1984,66:412-420.
17 Galpin RD, Roach JW, Wenger DR, et al. One-stage treatment of congenital dislocation of the hip in older children, including femoral shortening. J Bon Joint surg (Br), 1990,72:563-567.
18 Ryan MG, Johnson LO,Quanbeck DS,et al. One-stage treatment of congenital dislocation of the hip in children three to ten years old. Functional and radiographic results. J Bone Joint Surg (Am),1998,80:336-344.
19 张新，赵义，李长胜，等。大龄儿童先天性髋脱位治疗的几个问题。中华小儿外科杂志，1994，15(1)：
30-32。
20 彭明惺，胡廷泽，周锡华，等。髋骨切骨术治疗先天性髋关节脱位的长期随访和对手术的改进。中华小儿外科杂志，1989，4：195。
21 Gage JR, Winter RB. A vascular necrosis of the capital femoral epiphysis as complication of closed reduction of congenital dislocation of the hip.J Bone Joint Surg (Am)1972,54:373.