外固定架撑开固定治疗儿童股骨头无菌性坏死(附11例报告)

Stretch and fixation with external fixator for the treatment of Legg-Calve′-perthes disease(With a report of 11 cases)

目的 :探讨一种新的儿童股骨头无菌性坏死的治疗方法。方法 :根据不同分型的儿童股骨头无菌性坏死 ,选择股骨头钻孔减压术 ;血管束植入术 ;带血管骨块或骨膜瓣移植术。术后采用单侧外固定架将患髋关节撑开、固定 ,使关节间隙稍大于正常间隙 ,避免患侧股骨头在术后继续受压。结果 :所有病例经半年以上随访 (平均随访时间为 14个月 ) ,塌陷的股骨头骺均呈不同程度地抬起、变园 ;患髋关节功能基本恢复正常。结论 :本术式术后能降低关节内压力 ,有利于局部血循环重建 ,缩短病程 ,使患儿早期下地、站立及行走 。

Objective:To probe a new operative treatment for children′s legg perthes disease.Methods:According to the types of children′s leeg-perthes disease,drilling decompression or vascular bundle implantation or peddled iliac bone flap with vascular graft was chosen.The affected hip was stretched and fixed with external fixator postoperatively,let the gap of joint a little larger than the normal one ,so as to avoid the compression of the femoral head.Results:All cases were followed up at least half a year (average 14 months).All collapsed femoral heads raised and rounded out in varying degree.The functions of hip joint improved obviously.Conclusion:The inner pressure of hip joint was greatly reduced and the local blood supply was improved after the joint was stretched and fixed,the course of the disease was shortened.Thus made the children stand and walk early possible.The inconvenience of long time plaster fixation and its bedfast complications were avoided.