Kim Young-Jo, Novais Eduardo N
Department of Orthopaedic Surgery, Children's Hospital Boston, Boston, MA 02115, USA.
J Pediatr Orthop. 2011 Sep;31(2 Suppl):S235-40. doi: 10.1097/BPO.0b013e3182260252.
Residual hip deformities secondary to Legg-Calvé-Perthes disease (LCPD) include growth disturbance of the proximal femoral physis with nonspherical femoral head, overriding greater trochanter with short femoral neck and secondary remodeling of the acetabulum. These deformities can change the mechanical function of the hip joint and contribute to femoroacetabular impingement. All these deformities need to be recognized and its contribution to the patient's symptoms understood before a treatment strategy can be planned. Safe surgical dislocation of the hip allows for complete inspection of the hip joint and dynamic assessment of femoroacetabular contact during hip motion. The goals of this paper are to review the pathophysiology, clinical presentation, imaging findings, and the management of femoroacetabular impingement in patients with LCPD. We sought to present our treatment philosophy for patients who were diagnosed and treated for LCPD as a child and present with femoroacetabular impingement as adolescents and young adults.
莱-卡-佩病(Legg-Calvé-Perthes disease,LCPD)继发的残留髋关节畸形包括股骨近端骨骺生长紊乱伴股骨头非球形、大转子上移伴股骨颈短缩以及髋臼继发性重塑。这些畸形可改变髋关节的力学功能并导致股骨髋臼撞击。在制定治疗策略之前,所有这些畸形都需要被识别,并了解其对患者症状的影响。髋关节安全手术脱位可对髋关节进行全面检查,并在髋关节活动期间对股骨髋臼接触进行动态评估。本文的目的是回顾LCPD患者股骨髋臼撞击的病理生理学、临床表现、影像学表现及治疗。我们试图阐述对于儿童期被诊断和治疗为LCPD、青少年及年轻成人期出现股骨髋臼撞击的患者的治疗理念。