儿童股骨颈骨折早期治疗

Treatment of femoral neck fractures in children

目的股骨颈骨折患儿，采用早期复位、关节囊减压、骨折解剖复位、坚强内固定术治疗，观察在降低或避免股骨头坏死的作用。方法5例患儿的平均年龄为11岁5个月（9岁7个月～14岁）。男女之比为4：1。治疗方法是立即行切开复位。当达到解剖复位后，用2～3枚空心螺钉固定，螺钉均不穿过骺板。结果5例患儿均获得随访，平均随访时间37个月，全部患儿的骨折均愈合。5例无股骨头坏死发生。本组Harris评分为96-100分。5例Trendelenburg征均阴性。无下肢不等长和髋内翻。结论儿童股骨颈骨骨折的治疗，在伤后48h内，经切开复位，使骨折达到解剖复位、空心螺钉固定；抽吸或直视下清除关节囊淤血，缓解、降低关节囊内压力，可以避免股骨头颈部血运的再损伤，减少和降低股骨头坏死的发生率。

Objective To investigate the therapeutic results of femoral neck fractures in adolescence. Methods From March of 2000 to February of 2008.5 children with femoral nech fractures with displacement were treated in our hospital. There were 4 boys and 1 girl with a mean of 11.5 years old. When the fractures were immobilized by 2 or 3 hollow-screws. Cares were raken not to penetrate the Ratliff classification. Results All 5patients were followed up （mean time 37 months）. All fractures healed without AVN. The Harris score was 96-100 in the group, Trendlenburg signs were all negative, limb length discrepancy and coax vara were not noted. Conclusion This study shows open reduction and hollow-screw fixation to treat femoral fractures in adolescence can get the satisfactory results without occurrence of AVN.