外翻截骨治疗儿童Pauwels Ⅲ型陈旧性股骨颈骨折  

Valgus osteotomy for Pauwels type Ⅲ old femoral neck fracture in children

作　　者：王佳琦 李天友 王延宙 WANG Jia-qi;LI Tian-you;WANG Yan-zhou(Department of Pediatric Orthopedics,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东第一医科大学附属省立医院小儿骨科,山东济南250021

出　　处：《中国矫形外科杂志》2022年第6期547-550,共4页Orthopedic Journal of China

摘　　要：[目的]评价外翻截骨治疗儿童陈旧性股骨颈骨折疗效分析。[方法]2016—2021年对4例Pauwels III型陈旧性股骨颈骨折的患者行股骨外翻截骨、LCP-PHP固定。总结临床与影像资料。[结果]4例患者均顺利完成手术,手术时间(161.25±51.05)min,切口长度(10.75±2.98)cm,术中失血量(192.50±86.94)ml。切口均一期愈合。所有患者术后髋人字石膏固定6周。石膏拆除后1个月患肢不负重下地活动,3个月后恢复完全负重活动。所有患者均获随访9~23个月,平均(18.50±6.45)个月。随访过程中,患者均无再损伤,无翻修手术。与术前相比,末次随访时,患者的VAS评分显著下降(P<0.05),而Har⁃ris评分,髋关节屈伸ROM显著增加(P<0.05)。4例患者均行走正常,无明显跛行,下蹲活动正常,均恢复日常生活和运动能力。[结论]外翻截骨是治疗陈旧性股骨颈骨折的一种有效的治疗方式。[Objective]To evaluate the efficacy of valgus osteotomy for the treatment of Pauwels type III old femoral neck fracture in children.[Methods]From 2016 to 2021,4 patients with Pauwels TYPE III old femoral neck fracture were treated with valgus osteotomy of proximal femur with internal fixation by locking compression pediatric hip plate(LCP-PHP).The clinical and imaging documents were summarized.[Results]All the 4 patients were successfully operated on with operation time of(161.25±51.05)min,incision length of(10.75±2.98)cm,intraoperative blood loss of(192.50±86.94)ml,and primary healing of the incision.All patients had unilateral spica cast as external fixation for 6 weeks after surgery.The patients resumed actively affected limb motion without weight bearing one month after the cast removed,and then full weight-bearing activity 3 months later.All the patients were followed up for 9~23 months,with an average of(18.50±6.45)months.During the follow-up,there was no reinjury or revision surgery in anyone of them.The VAS score significantly de⁃creased(P<0.05),while Harris score and hip flexion-extension range of motion(ROM)significantly increased at the latest follow up com⁃pared with those preoperatively(P<0.05).At the latest follow up,all the 4 patients recovered normal walking without obvious claudication,whereas with normal squatting activities,and resumed normal daily life activity and sports capacity.[Conclusion]Valgus osteotomy is an ef⁃fective treatment for old femoral neck fracture in children.

关 键 词：陈旧性股骨颈骨折 外翻截骨 儿童 

分 类 号：R683.42[医药卫生—骨科学]