外科治疗儿童股骨颈骨折8例

Surgical treatment for the femoral neck fracture in children

目的儿童股骨颈骨折是一类严重的损伤,其潜在的、灾难性的并发症就是股骨头缺血性坏死。本文介绍股骨颈骨折的外科治疗方法,并分析股骨颈骨折后并发症的预防措施。方法1994年至2006年,共外科治疗8例儿童股骨颈骨折,其中男3例,女5例,平均年龄11(8～14)岁。创伤性骨折6例,陈旧性骨折2例;Ⅰ型骨折1例,Ⅱ型骨折2例,Ⅲ型骨折5例。1例采用单纯闭合复位髋人字石膏固定,5例行闭合复位、2枚直径6.5mm空心钉固定,1例用滑动鹅头钉加髋人字石膏固定,1例行关节融合、粗隆下截骨加髋人字石膏固定。结果均骨折愈合,术后8周左右拆除石膏,术后平均随访时间5(2～12)年。无一例出现股骨头缺血性坏死、髋内翻、骨折不愈合及骺板早闭。结论外科治疗儿童股骨颈骨折是确实有效的方法。

Objective Femoral neck fractures in chiklren are severe injuries associated with the potentially disastrous complication of femoral head necrosis. Our primary goal was to introduce surgical method and to identify what faetors eontrihute to the complications with femoral neck fractures in children. Methods We evaluated u series of pediatric patients with femoral neck fractures. Between 1994 and 2006, 8 patients with a mean age of 11 years （range, 8-14 years） with femoral neck fractures were identified. All traumatic epiphyseal, transeervical, and basieervieal （Types Ⅰ, Ⅱ, and Ⅲ） fractures were included. There were three male patients and five female patients. The mean follow-up was 5 years （range, 2-12 years）. Timing of surgery, type of fixation were analyzed. Results All hip fractures healed without complication; all had good or excellent reductions. The mean time to external fixation was 8 weeks. Conclusions Surgical treatment for the fetnoral neck fracture is an efleetive and definite procedure in children.