儿童急性股骨头骺滑脱症诊治分析

Diagnosis and management of acute slipped capital femoral epiphysis in children

目的 探讨儿童急性股骨头骺滑脱症的临床表现及放射影像学特征 ,治疗方法的选择。方法 回顾性总结我院 1993年 1月至 2 0 0 1年 5月收治的 7例儿童急性股骨头骺滑脱的临床资料 7例患儿中 ,男性 5例 ,女性 2例 ,年龄 10～ 14岁。轻度急性股骨头骺滑脱 3例 ,中度 2例 ,重度 2例。对于中轻度患儿 ,采用麻醉下股骨头骺滑脱闭合复位 ,对于重度患儿 ,闭合复位后予以克氏钢针固定。所有患儿均行髋人字形石膏固定 2～ 3个月。拆除石膏后支具固定 6～ 9个月 ,不负重下行髋关节主动功能锻炼。结果 7例患儿经非手术或手术治疗后 ,均治愈并且髋关节功能恢复正常。结论 对儿童急性股骨头骺滑脱患儿的及早诊断和合理治疗 。

Objective To explore clinical and imaging characteristics of acute slipped capital femoral epiphysis (SCFE) and the choice of therapy.Methods From 1993 to 2001,the clinical data of 7 children with acute SCFE were retrospectively analyzed.Among the 7 cases,3 were diagnosed as having mild acute SCFE,2 having moderate acute SCFE and 2 having severe acute SCFE.For the children with mild acute SCFE,closed reduction was performed under anesthesia.For those with severe acute SCFE,internal fixation with Kirschner pins was carried out after closed reduction.All cases had been fixed with gypsum for 2 to 3 months followed by fixation of trestle for 6 to 9 months.During the fixation of trestle,all cases were subjected to non-weight carrying training of hip joint.Results Of the 7 cases, all were cured by the non-operative or operative management and recovered their function of the hips.Conclusion The immediate diagnosis and therapy for the children with acute SCEF might play important roles in the recovery of the hip function and the prevention of the complications.