儿童髋部骨折治疗进展

Progress of hip fracture treatment in children

目的对儿童髋部骨折治疗相关进展进行综述。方法广泛查阅儿童髋部骨折治疗相关文献,从儿童髋部解剖与血供、骨折分型、手术治疗原则及并发症方面进行总结。结果儿童髋部解剖结构与周围血供随年龄增长而不断改变。Delbet分型为儿童髋部骨折经典分型标准,患儿年龄与Delbet分型对手术治疗策略及术后并发症的发生均存在显著影响。把握手术时机、解剖复位及选择适当的内固定可有效改善预后,降低并发症发生率。儿童髋部骨折常见并发症有股骨头缺血性坏死、髋内翻畸形、股骨头骺线早闭、骨折不愈合。结论儿童髋部骨折的治疗理念及内固定选择仍存在一定争议,需进一步研究儿童髋部解剖及血供特点,改进内固定器材及使用技巧,避免出现严重并发症。

Objective To review the progress of hip fracture treatment in children.Methods Literature about the hip fracture treatment in children was extensively reviewed and summarized in terms of anatomy and blood supply,fracture classification,surgical treatment principles,and complications.Results The anatomical structure of children’s hips and the characteristics of peripheral blood supply constantly change with age.Delbet classification is the most classic classification of hip fracture in children.Children’s age and Delbet classification have significant effects on surgical treatment strategies and post-fracture complications.The timing of surgical treatment,accurate anatomical reduction,and appropriate internal fixation can effectively improve the prognosis and reduce the incidence of complications.Common complications include osteonecrosis of the femoral head,coxa vara,premature physeal closure,and nonunion.Conclusion There are still some controversies on the treatment concept and internal fixation choice for children’s hip fracture.So it is necessary to further study the anatomy and blood supply characteristics of children’s hip,improve the selection and application skills of internal fixation devices,so as to avoid serious complications.