Forlin E, Guille J T, Kumar S J, Rhee K J
Alfred I. duPont Institute, Wilmington, Delaware 19899.
J Pediatr Orthop. 1992 Mar-Apr;12(2):164-8. doi: 10.1097/01241398-199203000-00004.
Five severely displaced transepiphyseal fractures of the neck of the femur in five very young children were treated nonoperatively with a spica cast. Four of these fractures healed in varus, but two with an open proximal femoral physis corrected with growth. One fracture had an 18-month delay in diagnosis and treatment, but subsequently healed after a valgus osteotomy of the proximal femur and bone grafting. There was no case of avascular necrosis. We recommend initial nonoperative treatment with hip spica cast immobilization for this type of fracture in the very young child. If correction of residual coxa vara or limb length discrepancy is indicated, it may be done later.
五名幼儿的五例严重移位的股骨颈经骨骺骨折采用髋人字石膏非手术治疗。其中四例骨折愈合后呈内翻，但有两例近端股骨骨骺开放的骨折随生长自行矫正。一例骨折诊断和治疗延迟18个月，但随后经股骨近端外翻截骨和植骨后愈合。无缺血性坏死病例。我们建议对幼儿的此类骨折最初采用髋人字石膏固定进行非手术治疗。如果需要矫正残留的髋内翻或肢体长度差异，可在后期进行。
