转子间内翻内移截骨术治疗Perthes病的远期效果

The long-term results of intertrochanteric varus medial-displacement osteotomy for Perthes disease

目的观察转子间内翻内移截骨术治疗Perthes病的远期疗效。方法对38例Perthes病患儿施行了转子间内翻内移截骨术,手术时年龄4～13岁,平均8岁10个月;Ⅱ期19例,Ⅲ期14例,Ⅳ期5例。平均随访7年(3～15年),根据临床表现和X线征象评定疗效,分析其远期效果。结果根据自拟的评定标准,优15例,良17例,可3例,差3例,总优良率84.2%;Ⅱ期患儿优良率94.7%,Ⅲ期85.7%,Ⅳ期40.0%。结论转子间内翻内移截骨术治疗Perthes病具有术式简单、损伤小、疗效良好等优点,值得推广应用。

Objective To observe the long term results of intertrochanteric varus medial displacement osteotomy(IVMDO) for Perthes disease. Methods Thirty eight patients with Perthes disease treated with IVMDO were reviewed. The results were evaluated based on a criteria made by the authors including clinical and radiographic parameters. The duration of follow up ranged from 3 to 15 years, with an average of 7 years. Results Fifteen patients were evaluated as having excellent result, 17 good, 3 fair and 3 poor respectively. The overall excellent or good rate was 84.2%. Considering the relationship between the outcome and staging of the disease, the overall excellent or good rate was 94.7% in stage Ⅱ lesion, 85.7%in stage Ⅲ lesion, and 40.0% in stage Ⅳ lesion. Conclusion The treatment of Perthes disease with IVMDO has the advantages of simple manipulation, less trauma and good results, and is worthy of populariztion.