Rowe Sung Man, Jung Sung Taek, Cheon Seung Young, Choi Jin, Kang Kyung Do, Kim Ki Hyeoung
Department of Orthopedic Surgery, Chonnam National University Hospital, Gwangju, Korea.
J Pediatr Orthop. 2006 Mar-Apr;26(2):204-10. doi: 10.1097/01.bpo.0000194696.83526.6d.
The authors report minimum 25-year follow-up results of cheilectomy performed in five hips affected by Legg-Calve-Perthes disease (LCPD) with hinged abduction. All five hips had a poor prognosis in terms of age at disease onset, treatment delay, hinged abduction, subluxation, and extensive head involvement. Cheilectomy, partial capital resection, was made along the indentation groove on the articular surface of the femoral head. Only the extruded portion of the femoral head was excised. Patients were placed in balanced suspension traction before and after surgery. Cheilectomy results were satisfactory during the early postoperative period (2-3 years) in terms of pain, range of motion, and limping. However, long-term results with a minimum follow-up of 25 years were unsatisfactory and showed poor hips in three, fair in one, and good in one. In addition, all five hips showed early evidence of osteoarthritic change (when patients were in their 30s). These results show that cheilectomy is not effective at preventing the early appearance of osteoarthritic change in LCPD hips with a deformed head and hinged abduction.
作者报告了对5例患有Legg-Calve-Perthes病(LCPD)并采用铰链式外展治疗的髋关节进行唇切除术的至少25年随访结果。就疾病发病年龄、治疗延迟、铰链式外展、半脱位和股骨头广泛受累而言,所有5个髋关节的预后均较差。唇切除术,即部分股骨头切除术,是沿着股骨头关节表面的压痕沟进行的。仅切除股骨头的突出部分。患者在手术前后均接受平衡悬吊牵引。就疼痛、活动范围和跛行而言,唇切除术后早期(2至3年)结果令人满意。然而,至少随访25年的长期结果并不理想,5个髋关节中3个预后差,1个一般,1个良好。此外,所有5个髋关节均在患者30多岁时出现早期骨关节炎改变迹象。这些结果表明,对于头部变形并采用铰链式外展治疗的LCPD髋关节,唇切除术无法有效预防骨关节炎改变的早期出现。