Wang En B, Ji Shi J, Zhao Qun, Zhang Li J
Department of Pediatric Orthopaedics, the Second Affiliated Hospital, China Medical University, Shenyang, People's Republic of China.
J Pediatr Orthop. 2007 Mar;27(2):165-70. doi: 10.1097/bpo.0b013e31802b711c.
We retrospectively reviewed 30 hips in 30 patients with complete destruction of the femoral head and neck from infantile septic arthritis to investigate the result and the ideal age for performance of trochanteric arthroplasty. All patients were treated with a 1-stage trochanteric arthroplasty at age from 11 to 98 months. We measured the range of motion of the hip, and we used the modified Harris hip score to evaluate pain and hip function and the multiplier growth-remaining method to assess predicted limb-length discrepancy. At a mean 7-year follow-up, we found that the modified Harris hip scores were negatively correlative--and the predicted limb-length discrepancy positively correlative--with the age at surgery in months. Range of motion in flexion and abduction of the hips of patients operated on at age older than 4 years were worse than that of the hips of patients operated on at age younger than 4 years. Therefore, we recommend that trochanteric arthroplasty should be performed as early as age 1 year for children with Hunka type V deformities after infantile septic arthritis of hip. Children older than 4 years might be contraindicated for trochanteric arthroplasty.
我们回顾性分析了30例因婴幼儿化脓性关节炎导致股骨头和颈部完全破坏的患者的30个髋关节，以研究转子成形术的效果及最佳手术年龄。所有患者均在11至98个月龄时接受了一期转子成形术。我们测量了髋关节的活动范围，采用改良Harris髋关节评分评估疼痛和髋关节功能，并使用乘数生长剩余法评估预测的肢体长度差异。在平均7年的随访中，我们发现改良Harris髋关节评分与手术时的月龄呈负相关，而预测的肢体长度差异与手术时的月龄呈正相关。4岁以上接受手术患者髋关节的屈曲和外展活动范围比4岁以下接受手术患者的髋关节更差。因此，我们建议对于髋关节婴幼儿化脓性关节炎后出现Hunka V型畸形的儿童，应在1岁时尽早进行转子成形术。4岁以上儿童可能不宜进行转子成形术。
