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小儿化脓性髋关节炎的简化关节镜灌洗:病例系列。

Simplified arthroscopic lavage of pediatric septic hip: case series.

机构信息

Department of Orthopaedics, Advocate Christ Medical Center, University of Illinois College of Medicine, Chicago, Illinois, USA.

出版信息

J Pediatr Orthop B. 2020 May;29(3):304-308. doi: 10.1097/BPB.0000000000000717.

Abstract

Septic arthritis of the pediatric hip is a surgical emergency that requires adequate lavage to decompress the hip, reduce degradative cartilage insult, and prevent coxarthrosis. In this report, we describe a simplified arthroscopic technique that may be performed using a single portal based on fluoroscopy and surface landmarks and without regular use of traction. We present results of a series of patients who underwent the simplified arthroscopic method for the management of pediatric septic hip. Data were obtained by a retrospective chart review of 13 consecutive patients (14 hips) with pediatric septic hip treated with arthroscopic lavage from 2010 to 2015. Age at the time of surgery ranged from 3 months to 8 years with three patients less than 1 year old. Ten hips (71%) returned for a routine follow-up with an average follow-up of 22 months. All 14 hips (100%) had complete resolution of symptoms. Two hips (14%) needed revision surgery due to inadequate response after the first lavage. One hip (7%) had transient femoral nerve palsy. Hip arthroscopy is an attractive and effective option for the management of pediatric septic hip. The limited equipment required and the ease of performing our simplified technique may broaden the application to the general orthopedist for the treatment of pediatric septic hip.

摘要

小儿髋关节化脓性关节炎是一种外科急症,需要充分灌洗以减轻髋关节压力、减少软骨降解损伤,并预防髋关节骨关节炎。本研究报告介绍了一种简化的关节镜技术,该技术可基于透视和体表标志,仅使用一个入路,无需常规使用牵引来完成。我们报告了一组连续的小儿髋关节化脓性关节炎患者接受简化关节镜治疗的结果。对 2010 年至 2015 年期间采用关节镜灌洗治疗的 13 例(14 髋)小儿髋关节化脓性关节炎患者进行了回顾性图表分析。手术时的年龄为 3 个月至 8 岁,其中 3 例小于 1 岁。10 髋(71%)接受了常规随访,平均随访 22 个月。所有 14 髋(100%)的症状完全缓解。由于首次灌洗后反应不佳,有 2 髋(14%)需要再次手术。1 髋(7%)出现短暂性股神经麻痹。髋关节镜检查是治疗小儿髋关节化脓性关节炎的一种有吸引力且有效的选择。所需设备有限,且我们的简化技术易于操作,这可能会使一般骨科医生更广泛地应用于治疗小儿髋关节化脓性关节炎。

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