Toro Giuseppe, Moretti Antimo, Paoletta Marco, De Cicco Annalisa, Braile Adriano, Panni Alfredo Schiavone
Department of Medical and Surgical Specialties and Dentistry, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.
EFORT Open Rev. 2020 Jan 29;5(1):58-64. doi: 10.1302/2058-5241.5.190019. eCollection 2020 Jan.
Hip fractures are severe conditions with a high morbidity and mortality, especially when the diagnosis is delayed, and if formulated over 30 days after the injury, is termed a 'neglected femoral neck fracture' (NFNF).Cerebral palsy (CP) is probably one of the major risk factors for NFNF in Western countries, mainly because of both cognitive and motor impairments. However, considering the high prevalence of fractures in these patients, the incidence of NFNF in this population is probably underestimated, and this condition might result in persistent hip or abdominal pain.Several techniques are available for the treatment of NFNF (i.e. muscle pedicle bone graft, fixation with fibular graft, valgisation osteotomy), but most of them could affect motor function.Motor function must be preserved for as long as possible, in order to enhance the quality of life of CP patients.After discussing published NFNF cases in CP patients and available treatment options, a practical approach is proposed to facilitate the orthopaedic surgeon to both early identify and appropriately manage these challenging fractures. Cite this article: 2020;5:58-64. DOI: 10.1302/2058-5241.5.190019.
髋部骨折是一种严重疾病，发病率和死亡率都很高，尤其是诊断延迟时。如果在受伤后30天以上才确诊，则称为“陈旧性股骨颈骨折”（NFNF）。在西方国家，脑瘫（CP）可能是NFNF的主要危险因素之一，主要是由于认知和运动障碍。然而，考虑到这些患者骨折的高发生率，该人群中NFNF的发病率可能被低估，而且这种情况可能导致持续的髋部或腹部疼痛。有几种技术可用于治疗NFNF（即肌蒂骨移植、腓骨移植固定、外翻截骨术），但其中大多数可能会影响运动功能。必须尽可能长时间地保留运动功能，以提高CP患者的生活质量。在讨论了已发表的CP患者NFNF病例和可用的治疗选择后，提出了一种实用方法，以帮助骨科医生早期识别并妥善处理这些具有挑战性的骨折。引用本文：2020；5：58 - 64。DOI：10.1302/2058 - 5241.5.190019。
