Vialle Raphaël, Odent Thierry, Pannier Stéphanie, Pauthier François, Laumonier Frédéric, Glorion Christophe
Department of Paediatric Orthopaedics, Necker-Enfants Malades Hospital, Paris, France.
J Pediatr Orthop. 2005 Mar-Apr;25(2):138-44. doi: 10.1097/01.bpo.0000151059.85227.ea.
Traumatic dislocation of the hip in childhood is uncommon and can be a consequence of minor trauma. The authors report a series of 35 dislocations in skeletally immature patients. Most were isolated posterior dislocations without acetabular lesions. In 75% of cases, reduction of the dislocation was easy. Nine children required surgery to remove interposed joint capsule and/or osteochondral fragments to achieve anatomic reduction. Outcomes were generally good, except in one patient in whom a displaced fracture of the femoral physis was followed by total head avascular necrosis. One case of partial necrosis had a satisfactory outcome. Epiphyseal necrosis, though uncommon, appeared to be inconsistent to prevent and hard to predict. Bone scan seems to be more effective than MRI for the detection of necrosis.
儿童外伤性髋关节脱位并不常见,可能由轻微创伤引起。作者报告了一组35例骨骼未成熟患者的脱位病例。大多数为单纯性后脱位,无髋臼损伤。75%的病例脱位复位容易。9名儿童需要手术切除嵌入的关节囊和/或骨软骨碎片以实现解剖复位。除1例患者股骨骨骺移位骨折后发生股骨头完全缺血性坏死外,总体预后良好。1例部分坏死病例预后满意。骨骺坏死虽然不常见,但似乎难以预防且难以预测。骨扫描在检测坏死方面似乎比MRI更有效。