Schofield C B, Smibert J G
Queen Mary's Hospital for Children Carshalton, England.
J Bone Joint Surg Br. 1990 Jan;72(1):32-6. doi: 10.1302/0301-620X.72B1.2298791.
We reviewed 14 patients (16 hips) treated by open reduction and upper femoral derotation osteotomy for congenital dislocation of the hip. Nine patients with 11 treated hips had growth deformities of the proximal femur; in all of them the top screw of the fixation plate lay within the cartilaginous precursor of the greater trochanter. In the five control hips the top screw was more distal. In the nine patients (mean follow-up 10.8 years) there was an increase of 14 degrees in the neck-shaft angle (p = 0.01) and of 18 degrees in the angle between the capital femoral physis and the shaft (p = 0.01) compared to the control group. This indicates that growth disturbance of the greater trochanteric apophysis as a result of plate fixation leads to long-term deformity.
我们回顾了14例(16髋)因先天性髋关节脱位接受切开复位及股骨上段旋转截骨术治疗的患者。9例患者(11髋接受治疗)存在股骨近端生长畸形;在所有这些患者中,固定钢板的顶端螺钉位于大转子的软骨前体范围内。在5例对照髋中,顶端螺钉位置更靠下。与对照组相比,9例患者(平均随访10.8年)的颈干角增加了14度(p = 0.01),股骨头骨骺与股骨干之间的角度增加了18度(p = 0.01)。这表明钢板固定导致的大转子骨骺生长紊乱会导致长期畸形。