From the Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC.
J Am Acad Orthop Surg. 2020 Jan 1;28(1):10-19. doi: 10.5435/JAAOS-D-17-00689.
Pediatric proximal femur fractures are high-energy injuries with predictable and morbid complications. Osteonecrosis of the femoral head is the most common complication with identified risk factors including fracture type, patient's age, degree of displacement, timing to reduction, and stability of fixation. Additional complications include nonunion, coxa vara, and premature physeal arrest. The mainstay of treatment for traumatic pediatric osteonecrosis is hip preservation with total hip arthroplasty being reserved as a salvage procedure. An anatomic fracture reduction and a biomechanically stable construct are critical to prevent both nonunion and osteonecrosis. This review will look at the individual surgical interventions for the management of the associated complications of pediatric proximal femur fractures.
小儿股骨近端骨折是一种高能损伤，具有可预测的和病态的并发症。股骨头坏死是最常见的并发症，其明确的危险因素包括骨折类型、患者年龄、移位程度、复位时间和固定的稳定性。其他并发症包括骨不连、髋内翻和骺板过早闭合。创伤性小儿股骨头坏死的主要治疗方法是髋关节保护，全髋关节置换术作为挽救性手术保留。解剖复位和生物力学稳定的构建对于预防骨不连和股骨头坏死至关重要。本综述将探讨小儿股骨近端骨折相关并发症的各种手术干预措施。
