Anari Jason B, Sankar Wudbhav, Hosseinzadeh Pooya, Baldwin Keith D
Instr Course Lect. 2019;68:443-452.
Proximal femoral fractures in the skeletally immature patient can be challenging for the orthopaedic surgeon to manage. This type of injury includes the femoral head/neck, intertrochanteric, and subtrochanteric fractures. The Delbet classification system historically describes all injuries in the pediatric proximal femur, except subtrochanteric fractures. Understanding the possible complications (coxa vara, osteonecrosis, premature physeal closure, nonunion) when managing these injuries can help with preoperative and intraoperative decision making. Although the understanding of proximal femur fractures has improved, many of the risk factors for poor outcomes in these injuries are not modifiable. Familiarity with the history, classification, complications, factors influencing the outcome, and management options available in 2018 will help improve the outcomes of pediatric proximal femur fractures.
对于骨骼未成熟患者的股骨近端骨折，骨科医生在处理时可能会面临挑战。这类损伤包括股骨头/颈骨折、转子间骨折和转子下骨折。历史上，德尔贝分类系统描述了小儿近端股骨的所有损伤，但不包括转子下骨折。了解处理这些损伤时可能出现的并发症（髋内翻、骨坏死、骨骺过早闭合、骨不连）有助于术前和术中的决策制定。尽管对股骨近端骨折的认识有所提高，但这些损伤预后不良的许多风险因素是无法改变的。熟悉2018年的相关病史、分类、并发症、影响预后的因素以及可用的治疗选择，将有助于改善小儿股骨近端骨折的治疗效果。
