Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA.
Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
J Orthop Trauma. 2019 Aug;33 Suppl 8:S22-S26. doi: 10.1097/BOT.0000000000001541.
Pediatric hip fractures are uncommon injuries but are associated with a high complication rate including avascular necrosis, coxa vara, nonunion, and premature physeal arrest. This is due in part to the unique anatomy of the proximal femur. Management principles are aimed at minimizing the risk of complications and emphasize the importance of early treatment with anatomic reduction and stable internal fixation with a low threshold for supplementing fixation with a spica cast. The age of the patient and Delbet fracture type dictate the optimal type of fixation for a given case. This article will offer evidence and experience-based tips intended to benefit on-call surgeons caring for these injuries.
小儿髋部骨折并不常见,但并发症发生率较高,包括缺血性坏死、髋内翻、骨不连和骺板早闭。这部分是由于股骨近端的独特解剖结构所致。治疗原则旨在最大限度地降低并发症风险,并强调早期治疗的重要性,即进行解剖复位和稳定的内固定,同时低阈值补充使用髋人字石膏固定。患者的年龄和 Delbet 骨折类型决定了特定病例的最佳固定类型。本文将提供循证和基于经验的提示,旨在使负责治疗这些损伤的值班外科医生受益。