年龄与腿-小牛-珀蒂斯病手术控制的临床和放射学结果相关的因素

Varinthorn Adulyanukosol, MD, Supphamard Lewsirirat, MD, Guntarat Chinvattanachot, MD
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引用次数: 1

摘要

目的:确定采用控制方法治疗的legg - calf - perthes病(LCPD)患者的临床和放射预后相关因素。方法:回顾性队列研究于2007 - 2017年进行。诊断为LCPD的患者处于碎片期,并采用手术控制方法进行治疗。研究因素包括诊断年龄,术前x线片分析侧柱分期和Catterall分型。结果测量为最终随访x线片,采用改进的Stulberg分级,以及最终临床结果,采用Harris髋关节评分。结果:我们分析了44个髋关节。受试者在诊断和随访时的平均年龄分别为8.1岁和12.7岁。平均随访时间58.6个月。19个髋部被评定为“好”(Stulberg I或II), 22个髋部被评定为“一般”(Stulberg III), 4个髋部被评定为“差”(Stulberg IV);没有髋部被划分为Stulberg v型,虽然没有显著性差异,但在bb ~ 8岁组中,Salter截骨联合股内翻截骨术的疗效优于单纯内翻截骨术(p=0.247)。年龄中位数为7(7 ~ 8)岁与Harris髋关节评分“良至优”相关,年龄中位数为9岁与“一般”和“差”得分显著相关(p=0.018)。侧柱A、B的疗效明显优于侧柱C (p=0.014)。结论:在治疗< 9岁的患者时,封闭方法显示出良好的效果。侧柱A和B的最终效果良好。骨盆和股骨联合截骨术可以改善影像学和临床预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Age and Factors Associated with Clinical and Radiological Outcomes of Surgical Containment in Legg-Calve-Perthes Disease
Purpose: To determine the factors associated with clinical and radiological outcomes in patients with Legg-Calve-Perthes disease (LCPD) treated with containment methods. Methods: This retrospective cohort study was conducted from 2007 – 2017. Patients diagnosed with LCPD in the fragmentation stage and treated using surgical containment methods were included. Study factors were age at diagnosis, preoperative radiographs analyzed for lateral pillar staging and Catterall classification. Outcome measurements were final follow-up radiograph, classified using modified Stulberg grading, and final clinical outcome, classified by Harris Hip Score. Results: We analyzed 44 hips. The average age of subjects during diagnosis and follow-up was 8.1 and 12.7 years, respectively. The average length of follow-up was 58.6 months. Nineteen hips were evaluated as “good” (Stulberg I or II), 22 hips as “fair” (Stulberg III), and four hips as “poor” (Stulberg IV); no hips were classified as Stulberg V. Although not significant, the combination of Salter osteotomy and femoral varus osteotomy yielded better outcomes than varus osteotomy alone in the group >8 years old (p=0.247). The median age of 7 (7 – 8) years old was correlated with “good to excellent” Harris Hip Score while median age of 9 years was significantly correlated with the score of “fair” and “poor” (p=0.018). Lateral pillar A and B yielded significantly better results than lateral pillar C (p=0.014). Conclusion: The containment methods demonstrated favorable outcomes when treating patients < 9 years. Lateral pillars A and B had good end results. Combined pelvic and femoral osteotomy can improve radiographic and clinical outcomes.
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