Singh Ajai, Srivastava Rajeshwar N, Shukla Prashant, Pushkar Amit, Ali Sabir
Department of Orthopaedics, King George's Medical University, Lucknow 226018, India.
Adv Orthop. 2014;2014:135236. doi: 10.1155/2014/135236. Epub 2014 Dec 14.
Background. Hip distraction in Perthes' disease unloads the joint, which negates the harmful effect of the stresses on the articular surfaces, which may promote the sound healing of the area of necrosis. We have examined the effect of arthrodiastasis on the preservation of the femoral head in older children with Perthes' disease. Methods and Materials. Twelve children with age more than 8 years with Perthes' disease of less than one year were treated with hip distraction by a hinged monolateral external fixator. Observation and Results. Mean duration of distraction was 13.9 days. These children were evaluated by clinicoradiological parameters for a mean period of 32.4 months. There was a significant improvement in the range of movements and mean epiphyseal index, but the change in the percentage of uncovered head femur was insignificant. There was significant improvement in Harris Hip score. Conclusions. Hip distraction by hinged monolateral external fixator seems to be a valid treatment option in cases with Perthes' disease in the selected group of patients, where poor results are expected from conventional treatment.
背景。佩特兹病中的髋关节撑开可减轻关节负荷，消除应力对关节面的有害影响，这可能促进坏死区域的良好愈合。我们研究了关节撑开对大龄佩特兹病患儿股骨头保留情况的影响。方法与材料。12例年龄超过8岁、患病时间少于1年的佩特兹病患儿采用单侧铰链式外固定器进行髋关节撑开治疗。观察与结果。平均撑开时间为13.9天。对这些患儿进行临床放射学参数评估，平均时长为32.4个月。活动范围和平均骨骺指数有显著改善，但股骨头未覆盖百分比的变化不显著。Harris髋关节评分有显著改善。结论。对于常规治疗预期效果不佳的特定佩特兹病患者群体，单侧铰链式外固定器进行髋关节撑开似乎是一种有效的治疗选择。
