【摘要】 目的 探讨儿童股骨颈骨折的外科治疗方法的选择问题。方法 收集并随访20例儿童股骨颈骨折,平均随访3年5个月,按Colonna分类,包括:Ⅰ型:骨骺分离3例;Ⅱ型:经颈骨折8例:Ⅲ型;基底部骨折5例;Ⅳ型:经转子骨折4例。所有患儿均采用闭合复位,其中Ⅰ型,Ⅱ型及Ⅲ型中移位明显不稳定者复位后采用克氏针内固定并行髋人字石膏固定4～6周;Ⅱ型及Ⅲ型中无移位者及Ⅳ型行髋人字石膏固定4～6周;Ⅱ型及Ⅲ型中无移位者及Ⅳ型行髋人字石膏固定4～6周。结果 临床及X线征象均较优者占65％,良好者20％,较差者15％,效果满意。结论 对于儿童股骨颈骨折,应该于基于解剖分型,X-线征象,以及其它临床表现进行“个体化”的治疗。更多还原

【Abstract】 Aim The purpose of the study is to assess he end - result of operative therapy to reat pediatric fracture of the femur neck, in children and adolescents. Methods End - result evaluations after and average follow - up of three years and five months are eported in twenty patients. There were three Type - 1 (transepiphyseal) , eight Type -Ⅱ(transcervical) , five Type -Ⅲ( cerivicotrochanteric) , and four Type - Ⅳ (intertrochanteric) femur fractures. The majority of Type- Ⅰ, displaced Type- Ⅲ fractures were treated with closed reduction and knowles- pin fixation.The majority of nudisplaced Type -Ⅲ and Type - Ⅳ factures were treated with abduction paster spica casts. Sixty - five per cent were found to have good results while 20 percent were fair adn 15 percent, poor. The incidence of complications - avascular necrosis, coxa vara, premature epiphyseal closure and non - union- was compared with that in previously reportedseries. The use of knowles- pin fixation appeard to reduce the complications o non- umion coxa vara. Avascular necrosis. Results The use of Knowles - pin fixation for displaced femoral neck fractures appeared to reduce the complications of non- union, coxa vora, avascular necrosis. Nooperative management such as hip spica is good for stable undisplaced features. Conclusion The choose of surical therapy should be depeaded on the patient s situation.更多还原