张志强;刘柱;李浩;李海;范清;杨璇;沈品泉;陈珽;张自明;

• 1:上海交通大学医学院附属新华医院儿骨科

摘要(Abstract)：

[目的]探讨开放与闭合复位是否会对儿童股骨颈骨折的延迟治疗结局产生不同的影响。[方法]收集2005年1月~2016年1月在本院儿骨科接受治疗的47例超过36 h复位的股骨颈骨折患儿,其中男28例,女19例。根据Delbet分类,I型1例,II型30例,III型11例,IV型5例。根据复位方式不同分为开放组(32例)和闭合组(15例)。随访采用Ratliff分级标准,并发症评估包括股骨头坏死、髋内翻及骺板早闭等。[结果]两组手术时间差异无统计学意义(P>0.05),但闭合组失血量明显少于开放组,差异有统计学意义(P<0.05)。所有患儿随访12~48个月,平均17个月。开放组9例发生股骨头坏死(28.12%),其中I型6例,II型2例,III型1例。2例(6.25%)患儿出现髋内翻,其中1例在术后20个月后行二次手术以纠正髋内翻畸形;1例(3.13%)发生骺板早闭。闭合组中发生股骨头坏死仅2例(13.33%),均为Ratliff股骨头坏死I型,未出现髋内翻等其他并发症。Ratliff评价标准,开放组优秀71.88%(23/32),良好28.12%(9/32);闭合组优秀80.00%(12/15),良好20.00%(3/15),两组优良率比较差异无统计学意义(P>0.05)。[结论]闭合复位和开放复位内固定对于延迟治疗的儿童股骨颈骨折都是有效的方法,但闭合复位内固定治疗的并发症发生率相对较少。股骨头坏死为儿童股骨颈骨折的主要并发症。

关键词(KeyWords)： 股骨颈骨折;延迟治疗;开放复位内固定;闭合复位内固定;儿童

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(编号:81372001)

作者(Author): 张志强;刘柱;李浩;李海;范清;杨璇;沈品泉;陈珽;张自明;

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DOI:

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