Joseph Benjamin, Nair N Sreekumaran, Narasimha Rao K L, Mulpuri Kishore, Varghese George
Paediatric Orthopaedic Service, Department of Orthopaedics, Kasturba Medical College, Manipal, Karnataka, India.
J Pediatr Orthop. 2003 Sep-Oct;23(5):601-6. doi: 10.1097/00004694-200309000-00006.
To identify the optimal timing for containment surgery for Perthes disease, the outcomes following femoral osteotomy of 97 children were analyzed. Univariate and multivariate analyses were employed to identify variables that influenced the shape and size of the femoral head at healing. The timing of surgery was an important variable that had a bearing on the outcome. The chances of retaining a spherical femoral head were much higher in children operated on either during the stage of avascular necrosis or in the early part of the fragmentation stage than in those operated later. The authors conclude that containment surgery aimed at preventing femoral head deformation in Perthes disease should be performed before the advanced stage of fragmentation. Further, any study on the outcome of containment treatment of Perthes disease must consider the timing of containment as a variable that influences the outcome while interpreting the results.
为确定佩特兹病包容手术的最佳时机，分析了97例儿童股骨截骨术后的结果。采用单因素和多因素分析来确定影响愈合时股骨头形状和大小的变量。手术时机是一个对结果有影响的重要变量。在无血管坏死阶段或碎裂阶段早期接受手术的儿童，保留球形股骨头的几率比那些较晚接受手术的儿童要高得多。作者得出结论，旨在预防佩特兹病股骨头变形的包容手术应在碎裂晚期之前进行。此外，任何关于佩特兹病包容治疗结果的研究在解释结果时都必须将包容时机视为一个影响结果的变量。
