Park Kwang-Won, Shah Ishani P, Ramanathan Ashok K, Lee Tae-Jin, Song Hae-Ryong
Institute for Rare Diseases and Department of Orthopaedic Surgery, Korea University Medical Center, Guro Hospital, Seoul, Republic of Korea.
J Pediatr Orthop B. 2017 Jul;26(4):329-335. doi: 10.1097/BPB.0000000000000399.
Although external fixation methods have been described for proximal femoral osteotomy for various etiologies, none are dedicated to a single disease entity. Our study introduces a technique of proximal femoral osteotomy and fixation with a monolateral external fixator system in Legg-Calvé-Perthes disease (LCPD). Twenty-three patients (19 males, four females) with LCPD underwent surgery at our institute between 2004 and 2012. Varus osteotomy (group A, 11 hips) and valgus osteotomy (group B, 12 hips) were performed and the monolateral external fixator system was used. The average age of patients at surgery was 13 years (6-23 years) and the mean follow-up duration was 21 months (12-64 months). The mean angular correction of the varus osteotomy in group A was 20° (10°-28°) and the mean medial displacement was 21% (10-49%). The angular correction of valgus osteotomy in group B was 28° (14°-49°) and lateral displacement was 41% (38-58%). The mean fixation time was 14 weeks (8.4-31 weeks). Complications occurred in nine hips (39.1%) and included pin-tract infections (five), hip abduction contracture (one), nonunions (two), and refracture (one). Our surgical technique provides precise correction and stable fixation with minimal intervention. Therefore, the monolateral external fixator could be considered an acceptable alternative fixation device for the correction of proximal femoral deformities in patients with LCPD.
Level IV, case series.
尽管已经描述了针对各种病因的股骨近端截骨的外固定方法，但没有一种是专门针对单一疾病实体的。我们的研究介绍了一种在Legg-Calvé-Perthes病（LCPD）中使用单侧外固定器系统进行股骨近端截骨和固定的技术。2004年至2012年间，23例LCPD患者（19例男性，4例女性）在我们研究所接受了手术。进行了内翻截骨（A组，11髋）和外翻截骨（B组，12髋），并使用了单侧外固定器系统。手术时患者的平均年龄为13岁（6 - 23岁），平均随访时间为21个月（12 - 64个月）。A组内翻截骨的平均角度矫正为20°（10° - 28°），平均内侧移位为21%（10 - 49%）。B组外翻截骨的角度矫正为28°（14° - 49°），外侧移位为41%（38 - 58%）。平均固定时间为14周（8.4 - 31周）。9髋（39.1%）出现并发症，包括针道感染（5例）、髋关节外展挛缩（1例）、骨不连（2例）和再骨折（1例）。我们 的手术技术以最小的干预提供了精确的矫正和稳定的固定。因此，单侧外固定器可被认为是矫正LCPD患者股骨近端畸形的一种可接受的替代固定装置。
IV级，病例系列。
