改良Salter三联截骨治疗儿童Perthes病

Improved Salter triple osteotomy in treatment of children Perthes disease

目的评价改良Salter三联截骨治疗儿童Perthes病（儿童股骨头缺血性坏死）的疗效。方法2004～2007年采用改良Salter三联截骨治疗儿童Perthes病50例（58侧）。有8例患儿为双侧发病。其中男39例，女11例。50例患儿共58侧股骨头坏死程度按Catterall分型均已达到Ⅲ～Ⅳ级。随访18个月至4年零6个月。结果随访术后全部病例，根据Mckay髋关节功能评分标准进行评价，优34例（38髋），良10例（12髋），优良率为86．2％；一般6例（8髋）。肢体平均短缩0．8cm（0．5～1．2cm），暂无骨关节炎的发生。结论三联截骨手术治疗儿童Perthes病能改善髋臼对股骨头的包容，使坏死的股骨头在髋臼内得到良好的塑形，逐步恢复骨骺高度，改善髋关节功能，并能阻止或降低骨关节炎的过早发生。该术式治疗儿童Perthes病具有临床价值，为儿童Perthes病提供了一种新的治疗方法。

Objective To study of the application of improved Salter triple osteotomy f the pelvic bone to treat the children Perthes disease. Methods From 2004 to 2007,50 cases were therapied with the method of triple osteotomy, followed up for 18 months to 4 years and 6 months. In the 50 cases（58 hips） ,39 males,11 females,the extent of the caput femoris＇ necrosis all reached grade Ⅲ. Results With the evidence of Mckay for the diseaser s prognosis,there were 34 cases of excellent, 10 cases of fine and 16 cases of common,The rate of fineness was 86.2%. The distance of crispation was 0.8cm on average （0.5-1.2cm）. OA did not occur. Conclusion This method can improve the relation that acetab contains caput femoris. It can also make the necrotis caput femoris gain molding favourably in acetab, reviving the height of osteoepiphysis,improving the joint function of hip, stopping hypertrophic arthritis taking place earlierly. In all,improved Salter triple osteotomy possesses the clinic value in treating children＇s Perthes disease. It offers a new method of treatment for this disease.