粗隆区双重截骨及软组织松解术治疗儿童股骨头缺血性坏死

Treatment of the Ischemic Necrosis of Femoral Head in Child with Double Intertrochanteric Osteotomy and Soft Tissue Relaxation

依据儿童股骨头缺血性坏死生物力学变化,设计股骨粗隆间双重截骨及软组织松解术的新术式治疗儿童股骨头缺血性坏死7例。其中CatterallⅡ期1例,Ⅲ期1例,Ⅳ期5例;股骨头危险征7例均有共27个,均有半脱位。随访19～41月,结果半脱位矫正6例、改善1例;股骨头危险征降至3例共5个,股骨头复圆3例、椭圆3例、扁平改善1例。对手术设计原理、手术方法、术式选择、本法优点作详细描述。

According to the biodynamic changes of ischemic necrosis of the femoral head in child, the double intertrochanteric osteotomy technique was devised, accompanying with soft tissue relaxation, as a new approach for curing these diseases. The actual method was performed clinically on 7 cases in our hospital, There were 1 case of Catterall stage Ⅱ, 1 case of stage Ⅲ, and stage Ⅳ 5 cases. Total 27 critical signs of femoral head were seen in all of the 7cases, and all of them suffered from subluxation of the related hip joint. All patients were followed up for 9～41 months The results obtained as follows: (1)There were total correction of subdislocation in 6 cases, improvement in 1 case; (2)The critical signs decreased to 5 in number among 3 cases; (3) There were 4 round heads, 3 oval heads, and improvement of the flat shaped femoral head in 1 case. It is described in detail the principle of the design for the reported technique, the operative approach, the choice of type of operation, and the advantages of this method.