内翻截骨加锁定加压钢板固定治疗腿-小腿- perthes病的功能效果

Duangjai Leeprakobboon, S. Sukpanichyingyong, T. Sangkomkamhang
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引用次数: 0

摘要

目的:对legg - calf - perthes病患者进行治疗以保持股骨头的圆度。手术治疗包括股骨近端或髋臼手术,但仍有争议。在此,我们研究了内翻截骨加锁定加压钢板固定的临床表现和结果。方法:我们回顾了19例(20髋)患有腿-小腿-佩尔特病的儿童,他们在我院接受了内翻截骨术和锁定加压钢板固定。术前和最后随访时记录再骨化时间、Stulberg分级和Harris髋关节评分。结果:我们纳入了单侧髋关节受累的16名男孩和2名女孩,以及双侧髋关节疾病的1名女孩。手术时的平均年龄为7.9岁。根据Catterall分级,分别有1例、10例和9例患者被分为II级、III级和IV级。所有患者随访33个月。平均再骨化时间为167天。在最后随访时,根据Stulberg分级,分别有7例、9例和4例患者被分为II级、III级和IV级。根据Harris髋关节评分,21.1%、47.7%和31.6%的患者分别表现出极好、良好和一般的功能结果。与术前相比,Harris髋关节评分在最后的随访中有显著改善。调整性别和疾病严重程度后,发病年龄和手术时间与Harris髋关节评分相关。结论:内翻截骨加锁定加压钢板固定效果良好,可显著改善功能预后,但患者年龄会影响结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Functional Outcomes of Varus Osteotomy with Locking Compression Plate Fixation in Legg-Calve-Perthes Disease
Purpose: Patients with Legg-Calve-Perthes disease are treated to preserve the roundness of the femoral head. Surgical treatment includes the proximal femur or acetabulum operations, however, remains controversial. Herein, we investigated the clinical findings and outcomes of varus osteotomy with locking compression plate fixation. Methods: We reviewed 19 children (20 hips) with Legg-Calve-Perthes disease who underwent varus osteotomy with locking compression plate fixation at our hospital. The time to re-ossification, Stulberg classification, and Harris hip score were recorded preoperatively and at the final follow-up. Results: We included 16 boys and two girls with unilateral hip involvement and one girl with bilateral hip disease. The mean age at the time of surgery was 7.9 years. Based on the Catterall classification, one, 10, and nine patients were classified as grades II, III, and IV, respectively. All patients were followed for 33 months. The mean time to re-ossification was 167 days. At final follow-up, based on the Stulberg classification, seven, nine, and four patients were categorized as class II, III, and IV, respectively. Based on the Harris hip score, 21.1%, 47.7%, and 31.6% of patients showed excellent, good, and fair functional outcomes, respectively. The Harris hip scores at the final follow-up were significantly improved compared to preoperative values. Following adjustment for sex and disease severity, age at disease onset and time of surgery were associated with Harris hip scores. Conclusions: Varus osteotomy with locking compression plate fixation yields good results and significantly improves functional outcomes, although patient age affects the outcomes.  
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