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[急性股骨头骨骺滑脱。病因——手术治疗——结果]

[Acute slipped femur head epiphysis. Causes--surgical treatment--results].

作者信息

Heisel J

出版信息

Aktuelle Traumatol. 1987 Apr;17(2):48-54.

PMID:2884825
Abstract

The juvenile slipped capital femoral epiphysis depends on a dysendocrinia during puberal acceleration. The weakening of mechanical stability of the epiphyseal cartilage leads in most of the cases to a slow, only in some cases to an acute dorsocaudal slipping of the capital femoral epiphysis. Representation of our own patients of Orthopedic University Hospital D-Homburg/Saar with altogether 27 acute slipped capital femoral epiphyses during the years 1965-1981. The early operative stabilisation seems to be most important for a good prognosis (danger of development of femoral head necrosis). The opening of the hip joint during the operation by a ventral capsulotomy facilitates the reduction and decompresses the haematoma. In consideration of the mostly slow beginning, in many cases an ideal correction could not be achieved in most of the patients. In contrast to the osteosynthesis by screws the growth in length is less influenced by using a lamellar nail or Kirschner-wires. In cases of an acute slipped capital femoral epiphysis a first conservative treatment with subsequent correction osteotomy does not seem to be justifiable, because the danger of femoral head necrosis raises drastically. In case of opportune operation and correct technique good to fair functional results can be achieved.

摘要

青少年股骨头骨骺滑脱取决于青春期加速期的内分泌失调。骨骺软骨机械稳定性减弱在大多数情况下会导致股骨头骨骺缓慢滑脱,仅在某些情况下会导致急性向背尾侧滑脱。介绍了1965年至1981年间德国洪堡/萨尔大学骨科医院共27例急性股骨头骨骺滑脱患者的情况。早期手术稳定对良好预后(股骨头坏死发展的风险)似乎最为重要。手术时通过前方关节囊切开术打开髋关节便于复位并减轻血肿。考虑到发病大多较为缓慢,在大多数患者中,很多情况下无法实现理想的矫正。与螺钉内固定相比,使用板层钉或克氏针时长度生长受影响较小。在急性股骨头骨骺滑脱的情况下,首先进行保守治疗随后进行矫正截骨术似乎不合理,因为股骨头坏死的风险会大幅增加。如果手术时机合适且技术正确,可以取得良好至中等的功能结果。

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