带阔筋膜张肌髂骨瓣移植治疗儿童股骨颈骨折  

Treatment of femoral neck fractures in children with iliac bone flap graft with tensor fasciae latae

作　　者：占蓓蕾[1] 叶舟[1] 

机构地区：[1]衢州市人民医院,浙江衢州324000

出　　处：《中国骨伤》2005年第12期743-744,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨儿童股骨颈骨折的治疗方法,并对其疗效进行评定.方法:本组儿童股骨颈骨折12例,男7例,女5例;年龄7～15岁,平均10.5岁.损伤按Delbet分型:Ⅰ型1例,Ⅱ型6例,Ⅲ型4型,Ⅳ型1例.全部病例均行切开复位、多枚克氏针固定,并应用带阔筋膜张肌髂骨瓣移植,以促进骨折愈合.结果:经平均4.5年随访,所有骨折均解剖复位,无切口感染及断针情况发生,除Ⅰ型1例发生股骨颈变短、骺板早闭,Ⅱ型2例发生股骨头缺血性坏死外,其余病例骨折均愈合.按赵东升等功能评定标准:优6例,良3例,差3例,优良率达75%.结论:多枚克氏针呈三角锥形固定具有较强的抗水平剪力及旋转应力,固定可靠,阔筋膜张肌的营养血管行走恒定,血供丰富,髂骨块切取后对患儿的肢体功能和形态无影响,是治疗儿童股骨颈骨折比较理想的一种方法.Objective： To studty effective method for the treatment of femoral neck fractures in children, and to evaluate its therapeutic effects. Methods：Twelve patients with femoral neck fractures（7 male and 5 female, with the average age of 10.5 years, ranging in age from 7 to 15 years） were reviewed. According to Del- bet classification, 1 patient was type Ⅰ ,6 type Ⅱ ,4 type Ⅲ and 1 type Ⅳ .All the patients were treated with open, multi-pin fixation, and iliac bone flap graft with tensor fasciae latae to accelerate fracture union. Results： All the patients were followed up for an average of 4.5 years. All the fractures reached anatomic reduction, and no complications such as infection of incision-induced wound and pin breaking occurred. All the patients obtained fracture healing except that 1 patient of type I had femoral neck shorting with epiphyseal plate closing early, and 2 patients of type ]1 had avascular necrosis of the femoral head. According to Dongsheng Zhao＇s evaluation criteria, 6 patients had excellent results, 3 good and 3 fair. The excellent-and-good rate was 75 %. Conclusion： Fixation with multi-pin in triangular taper shape had such advantages as better anti-shear force and anti-rotation effect with reliable fixation. The nutrient vessel of tensor fasciae latae has abundant blood supply and no effects on children＇s extremity functions and form was produced by cutting iliac bones. This method is very effective to treat femoral neck fractures in children.

关 键 词：股骨颈骨折 儿童 骨移植 

分 类 号：R683.42[医药卫生—骨科学] R617[医药卫生—外科学]