牵引加原位穿针（钉）治疗儿童股骨头骺滑脱

Russel distraction with screw or pin fixation for children with slipped capital femoral epiphysis

目的研究改良Russell牵引加原位穿针（钉）在治疗儿童股骨头骺滑脱中的应用。方法回顾1995年8月至2006年8月，我科收治并获得随访的SCFE病例42例，其中男30例，女12例。所有患儿术前均行改良Russell牵引，评价该牵引方法对股骨头骺复位的作用，然后行原位穿针（钉）术，术后对患儿进行随访，观察该治疗方法对患儿髋关节功能的影响情况。结果Russell牵引可明显改善股骨头骺脱位情况，42例SCFE患儿中，采用牵引加原位穿针（钉）固定方法治疗的共33例，其中除2例患儿牵引无效及术后髋关节功能恢复差之外，其余患儿均得到满意效果。结论改良Russell牵引加原位穿针（钉）治疗可最大限度保留SCFE患儿髋关节功能，临床疗效满意。

Objective To investigate the modified Russell distraction with screw or pin fixation in the treatment of slipped capital femoral epiphysis （SCFE） . Methods From August 1995 to April 2006, 42 cases of SCFE who were treated with modified Russell distraction with screw or pin fixation were retrospectively analyzed. There were 30 males and 12 females. The average age of the patients was 10. 3 years （ranging from 7 years to 14 years）. Russell distraction was performed in all patients before pin or screw fixation, and its therapeutic effect in epiphysis alignment were evaluated. All patients were followed up to assess their hip function according to Harris and Charnly score system. Results The apposition of femoral head epiphysis was effectively improved by Russell distraction. In all the patients with SCFE, 33 cases who accepted the Russell distraction with screw or pin fixation in situ recovered satisfactorily except 2 patients who got poor therapeutic effects of distraction and poor recovery of hip function. The Southwick angle was improved in all patients. Conclusions Modified Russell distraction with screw or pin fixation can reserve satisfactory hip function and achieve good therapeutic effects.