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采用改良Dunn截骨术并手术性髋关节脱位治疗青少年股骨头骨骺滑脱。

Adolescent slipped capital femoral epiphysis treated by a modified Dunn osteotomy with surgical hip dislocation.

作者信息

Huber H, Dora C, Ramseier L E, Buck F, Dierauer S

机构信息

Kinderspital Zürich, Steinwiesstrasse 75, 8032 Zürich, Switzerland.

出版信息

J Bone Joint Surg Br. 2011 Jun;93(6):833-8. doi: 10.1302/0301-620X.93B6.25849.

Abstract

Between June 2001 and November 2008 a modified Dunn osteotomy with a surgical hip dislocation was performed in 30 hips in 28 patients with slipped capital femoral epiphysis. Complications and clinical and radiological outcomes after a mean follow-up of 3.8 years (1.0 to 8.5) were documented. Subjective outcome was assessed using the Harris hip score and the Western Ontario and McMaster Universities osteoarthritis index questionnaire. Anatomical or near-anatomical reduction was achieved in all cases. The epiphysis in one hip showed no perfusion intra-operatively and developed avascular necrosis. There was an excellent outcome in 28 hips. Failure of the implants with a need for revision surgery occurred in four hips. Anatomical reduction can be achieved by this technique, with a low risk of avascular necrosis. Cautious follow-up is necessary in order to avoid implant failure.

摘要

2001年6月至2008年11月期间,对28例股骨头骨骺滑脱患者的30髋实施了改良邓恩截骨术并进行手术性髋关节脱位。记录了平均随访3.8年(1.0至8.5年)后的并发症以及临床和放射学结果。使用Harris髋关节评分和西安大略和麦克马斯特大学骨关节炎指数问卷评估主观结果。所有病例均实现了解剖或接近解剖复位。1髋的骨骺在术中显示无血运并发生了缺血性坏死。28髋获得了优异的结果。4髋出现植入物失败,需要翻修手术。通过该技术可实现解剖复位,缺血性坏死风险较低。为避免植入物失败,必须进行谨慎的随访。

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