儿童及青少年髂前上棘撕脱骨折手术与非手术治疗对比研究

Comparative study on conservative and surgical treatment of anterior-superior iliac spine avulsion fractures in children and adolescents

目的对比分析儿童及青少年髂前上棘撕脱骨折的治疗方法。方法回顾性分析2009年1月1日至2014年12月31日在该院诊断为髂前上棘撕脱骨折的44例患儿的临床资料。根据治疗方式将其分为手术组24例和非手术组20例。手术组采用骨折切开复位可吸收螺钉内固定术的手术方法,非手术组采用屈髋屈膝卧床休息的保守治疗方法。结果两组患儿均获得随访,随访时间1~7年,平均4.0年,手术组患儿均骨性愈合,髋关节活动度正常,恢复正常运动,无可吸收螺钉脱出、骨折不愈合、切口感染、大腿前外侧皮肤感觉减退表现。非手术组患儿均骨性愈合,1例出现延迟愈合,愈合时间为6.5个月,1例出现髋部及大腿外侧不适感,自行缓解。结论髂前上棘撕脱骨折后手术切开复位可吸收螺钉固定较非手术治疗愈合快,功能恢复早,可以早期活动,防止关节僵硬,可吸收螺钉不需要取出,避免二次手术。

Objective To compare and analyze the treatments of anterior-superior iliac spine avulsion fractures in children and adolescents. Methods Clinical datas of 44 cases diagnosed as the anterior-superior iliac spine avulsion fractures from January 1,2009 to December 31,2014 in our hospital were retrospective analyzed. According to the treatment method ,the pa- tients were divided into the surgical group （n=24） and the conservative group （n=20） . The surgical group was treated by open re- duction and absorbable screw fixation,the conservative group was received a conservative treatment of resting with hip and knee flexion. Results Children in the two groups were followed up for 1-7 years, average 4.0 years. In the surgical group, all the cases were osseous healing ,hip joint activities were normal and back to normal movement, no absorbable screws prolapse, nonunion incision infection and lateral thigh skin hypesthesia were observed. In the conservative group, all cases were osseous healing too, while one case appeared delayed healing, the healing time was 6.5 months, one case showed hip and thigh lateral discomfort, but self-relieved. Conclusion Comparison of conservative against surgical treatment of open reduction and absorbable screw fixation of anterior-superior iliae spine avulsion fractures, patients with surgical treatment heal faster, function recovery earlier, can carried out early activity and prevent the stiff joints, furthermore, the absorbable screws do not need to be removed, which avoiding secondary operation.