Imhäuser G
Z Orthop Ihre Grenzgeb. 1976 Dec;114(6):970-8.
The initial results following operations on the proximal end of the femur in children may not be permanent. They are frequently altered by further growth of the bone. This influence of growth on the operative result cannot always be predicted. The author reports 6 cases with poor results following operations on the proximal end of the femus. In 3 children varus-rotation osteotomies resulted in pseudarthrosis and/or severe angulation. Resection of a solitary bone cyst and operative treatment of fractures of the proximal femur in 2 other cases produced similar complications. Treatment of these undesirable results consisted of osteotomy with correction in all 3 dimensions and medial displacement of the shaft under the neck of the femur. Fixation of the fragments was obtained with traction-bracing according to Pauwels. The early results were good in all cases. The author concludes that an operation on the proximal end of the femur in children is indicated only when absolutely necessary and when it is fairly certain that growth cannot alter the results unfavorably. Only those procedures should be recommended which have been shown to give satisfactory results in an adequate number of cases that remain unaltered throughout the entire growth period.
儿童股骨近端手术后的初期结果可能并非永久性的。它们常常会因骨骼的进一步生长而改变。生长对手术结果的这种影响并非总能预测。作者报告了6例股骨近端手术后效果不佳的病例。在3名儿童中，内翻旋转截骨术导致了假关节形成和/或严重成角。另外2例中，孤立性骨囊肿切除及股骨近端骨折的手术治疗也产生了类似的并发症。对这些不良结果的治疗包括在三个维度上进行截骨矫正，并将股骨干向股骨颈下方内侧移位。根据 Pauwels 法采用牵引支具固定骨折碎片。所有病例的早期结果均良好。作者得出结论，仅在绝对必要且相当确定生长不会对结果产生不利影响时，才对儿童股骨近端进行手术。仅应推荐那些在足够数量的病例中已显示出令人满意的结果且在整个生长期间保持不变的手术方法。
