儿童股骨头无菌坏死疗效分析

A comperative study of the results of treatment of Legg-Perthes disease in children

报告３０例（３５髋）股骨头无菌坏死治疗结果。随诊期４～１２．５年。可供分级的３１髋皆属Ｃａｔｔｅｒａｌ１Ⅲ、Ⅳ组。保守治疗１１髋，滑膜切除１０髋，血管植入７髋，髋臼造盖３髋，髂骨截骨３髋，内收肌松解１髋。按Ｓｔｕｌｂｅｒｇ标准评定，优良率３１．４％，差２２．９％。疗效差原因为（１）发病年龄大，８岁以上占半数；（２）病情重，８８．６％病例属ＣａｔｔｅｒａｌｌⅢ、Ⅳ组；（３）来院就诊晚，股骨头多已严重变形。保守治疗组与手术治疗组疗效比较无明显差别。病变修复前限制患肢负重是防止股骨头变形、控制病情恶化的有效举措。

AbstractThe results of treatment of 30 cases(35hips )of Legg-Perthes disease were reviewed.There were 31 hips be-longed to group Ⅲ or Ⅳ according to Catterall’s classifi-cation.4 hips were ont fit for classification.Conservativetreatment was used in 11 hips .Synovectomy was done in 10, vascular implantation in 7, shelf operation in 3,Chiariosteotomy in 3 and adductor release in one. The results of treatment were evaluated according to the criterion of Stulberg. The follow-up period extended for 4 to 12.5years.The total excellent rate was 31.4%,poor 22.9%.The poor results were possibly caused by:1.the senior ageof the patients ,2.more severe involvement of the femoralhead in patients of Catterall group Ⅲ and IV(88.6%),3. delayed treatment with the femoral head severely de-formed.No evident differences were found between the results of conservative and operative treatment.Durong the stage of creeping -subetitution , withholding weight-bearing of the affected leg is an effective measure for pre-venting deterioration and deformity of the femoral head.