Ngom Gabriel, Ngaringuem Olivier, Munyali Desir Allumeti, Fall Mbaye, Ndour Oumar, Ndoye Mamadou
Department of Pediatric Surgery, Cheikh Anta Diop University, Dakar, Senegal.
Afr J Paediatr Surg. 2011 May-Aug;8(2):190-3. doi: 10.4103/0189-6725.86060.
To report on a radiological issue and therapeutic aspects encountered in septic hip dislocations in a developing country.
Nineteen children among whom 11 boys and 8 girls aged on average 5.3-years old presented 7 recent and 12 late hip dislocations. Those dislocations were distributed into in category 1: dislocations without associated lesion; category 2: dislocations associated with minor lesions; category 3: dislocations associated with major lesion. Ten children who presented an elevated erythrocyte sedimentation rate (ESR) received antibiotics. An arthrotomy was performed in children with a recent dislocation. Traction was performed in all children with an average duration of 5 weeks. The results were considered good, intermediate or bad using two parameters: ESR and reduction of dislocation.
2 category 1 dislocations, 6 category 2 dislocations and 11 category 3 dislocations were noted. As concerns the recent dislocations, there were 2 category 1 dislocations and 5 category 2 dislocations. For late dislocations, 1 category 2 and 11 category 3 dislocations were recorded. There were 8 good results and 11 bad results. The good results concerned 7 recent dislocations and one late dislocation. The bad results concerned exclusively late dislocations.
In children with septic hip dislocations, the good results concern almost exclusively recent dislocations but arthrotomy and immobilization must be done early.
报告在一个发展中国家发生的化脓性髋关节脱位所遇到的放射学问题及治疗方面的情况。
19名儿童，其中11名男孩和8名女孩，平均年龄5.3岁，出现7例近期髋关节脱位和12例晚期髋关节脱位。这些脱位被分为1类：无相关损伤的脱位；2类：伴有轻微损伤的脱位；3类：伴有严重损伤的脱位。10名红细胞沉降率（ESR）升高的儿童接受了抗生素治疗。对近期脱位的儿童进行了关节切开术。所有儿童均进行了牵引，平均持续时间为5周。使用两个参数ESR和脱位复位情况将结果分为良好、中等或差。
记录到2例1类脱位、6例2类脱位和11例3类脱位。关于近期脱位，有2例1类脱位和5例2类脱位。对于晚期脱位，记录到1例2类脱位和11例3类脱位。有8个良好结果和11个不良结果。良好结果涉及7例近期脱位和1例晚期脱位。不良结果仅涉及晚期脱位。
在化脓性髋关节脱位的儿童中，良好结果几乎仅涉及近期脱位，但必须尽早进行关节切开术和固定。
