股骨近端外翻截骨植骨术治疗儿童股骨颈骨折骨不连的疗效探讨

Efficacy of valgus intertrochanteric osteotomy and bone grafting for nonunion of femoral neck fracture in children

目的评估股骨近端外翻截骨植骨术治疗儿童股骨颈骨折骨不连的疗效。方法回顾性分析2011年1月至2022年1月复旦大学附属儿科医院骨科收治的8例股骨颈骨折骨不连患儿临床资料,均采用股骨近端外翻截骨、髋加压锁定钢板固定,并对骨不连区域行植骨治疗,观察股骨髋内翻改善情况、骨不连愈合以及手术后并发症情况。结果8例股骨颈骨折骨不连患儿行股骨近端外翻截骨植骨术后均痊愈,随访时间(14.5±3.9)个月,愈合时间为(9.5±2.1)个月。术后1年随访时股骨颈干角为(145.6±9.8)°,较手术前股骨颈干角(117.6±17.0)°增加,股骨颈干角异常得到纠正,差异有统计学意义(t=4.310,P<0.05),术后发生伤口感染1例,经抗生素对症治疗3周后痊愈。结论股骨近端外翻截骨植骨术治疗儿童股骨颈骨折骨不连疗效确切,可有效纠正股骨髋内翻畸形。

Objective To evaluate the efficacy of valgus intertrochanteric osteotomy for nonunion of femoral neck fracture in children.Methods From 2011 to 2022,8 children with a nonunion of femoral neck fracture underwent valgus intertrochanteric osteotomy,pediatric hip plate and bone grafting.The major objectives were the improvement of femoral neck shaft angle and healing time of nonunion femoral neck,while recording postoperative complications.Results The average healing time was(9.5±2.1)months,the average preoperative neck shaft angle(117.6±17.0)°and the 1-year post-operative neck shaft angle(145.6±9.8)°.Abnormal neck shaft angle was corrected after surgery(P=0.0035).Conclusion Valgus intertrochanteric osteotomy and bone grafting are efficacious for nonunion of femoral neck fracture.