儿童股骨颈骨折后发生股骨头坏死相关因素的研究进展

Advances in study on factors related to avascular necrosis of the femoral head after paediatric femoral neck fractures

儿童股骨颈骨折在儿童骨折中占比不到1%,非常少见,其发生机制一般是由高能量创伤造成。若儿童股骨颈骨折不能得到及时有效治疗,发生股骨头坏死(avascular necrosis of the femoral head,AVN)、髋内翻、骨不连、股骨近端骨骺早闭、双下肢不等长等并发症的概率极高,相较于并发症发生率更高的保守治疗方法,目前更推荐手术治疗。AVN是最常见也是最难处理的并发症之一,目前尚无有效的治疗措施和可靠的预测因子,儿童一旦发生,预后多不理想。另外,影响AVN发生的相关因素也一直存在争议。因此,本文结合近十年的文献报道,对儿童股骨颈骨折后发生AVN相关因素的研究进展作一综述。

Femoral neck fractures in pediatric fractures account for less than 1%which is very rare,and its mechanism is commonly caused by high-energy trauma.If children with femoral neck fracture cannot receive timely and effective treatment,they are at high risk of avascular necrosis of the femoral head(AVN),coxa vara,bone nonunion,premature physeal closure,leg length discrepancy and other complications.Surgical treatment is currently preferred over conservative treatment,which has a higher complication rate.Among them,AVN is one of the most common and the most difficult complications to manage.So far,no effective treatment measures and reliable predictors have been reported,and the related factors affecting the occurrence of AVN have also been controversial.Once femoral head necrosis occurs in children,the prognosis is not ideal due to the lack of appropriate treatment methods.Therefore,this paper reviews the research progress on the related factors of AVN after femoral neck fracture in children based on the literature reports in the past decade.