Akakpo-Numado Gamedzi Komlatsè, Gnassingbe Komla, Sakiye Kodjo Abossisso, Boume Missoki Azanlédji, Amadou Abdoulatif, Tekou Hubert
Service de chirurgie pédiatrique du CHU Tokoin de Lomé, BP 57, Lomé, Togo.
Sante. 2008 Oct-Dec;18(4):231-3.
To identify the epidemiological, clinical and therapeutic aspects of hip-joint disorders in children with sickle cell disease, to point out the diagnostic problems, and to stress the necessity of early diagnosis for optimal outcome.
This retrospective study, conducted from January 1987 through December 2006, included children with at least one haemoglobin S gene and hospitalised for osteonecrosis of the femoral head. Ficat staging was used.
The study included 14 children (12 boys and 2 girls) with a mean age of 14 years, all hospitalised and treated for osteonecrosis of the femoral head during the study period 8 SS and 6 SC. Osteonecrosis of the femoral head was diagnosed at Ficat stage 3 in 8 cases and at stage 4 in 6. Ten children (8 at stage 3 and 2 at stage 4) had orthopaedic treatment (continuous traction for 30 days and then a Thomas's splint for a mean 14 months). Outcome was good for 6 of the stage-3 cases (mean follow-up period 9 years) and poor for the other patients with purely orthopaedic treatment (mean follow-up period 11 years). Four children at stage 4 underwent surgery (varus osteotomy, immobilization in a cast for 8 weeks, and then Thomas's splint for a mean 12 months) with good results (mean follow-up period 10 years).
Early diagnosis, assisted by computed tomography, magnetic resonance imaging or scintigraphy, makes it possible to provide better treatment and preserve hip function.
确定镰状细胞病患儿髋关节疾病的流行病学、临床及治疗方面，指出诊断问题，并强调早期诊断对于获得最佳预后的必要性。
这项回顾性研究于1987年1月至2006年12月进行，纳入了至少携带一个血红蛋白S基因且因股骨头坏死住院的儿童。采用Ficat分期。
该研究纳入了14名儿童（12名男孩和2名女孩），平均年龄14岁，在研究期间均因股骨头坏死住院并接受治疗，其中8例为SS型，6例为SC型。股骨头坏死在Ficat 3期诊断出8例，4期诊断出6例。10名儿童（3期8例，4期2例）接受了骨科治疗（持续牵引30天，然后使用托马斯夹板平均14个月）。3期的6例患者预后良好（平均随访期9年），而其他单纯接受骨科治疗的患者预后较差（平均随访期11年）。4期的4名儿童接受了手术（内翻截骨术，石膏固定8周，然后使用托马斯夹板平均12个月），结果良好（平均随访期10年）。
借助计算机断层扫描、磁共振成像或骨闪烁显像进行早期诊断，能够提供更好的治疗并保留髋关节功能。
