哪些因素会导致崔氏IV型后遗症？对15例化脓性髋部病例的回顾性分析。
What factors contribute to Choi IV sequelae? A retrospective analysis of 15 septic hips.
作者信息
Agarwal Anil, Rastogi Prateek
机构信息
Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, 11003, India.
出版信息
J Clin Orthop Trauma. 2020 Jul;11(Suppl 4):S645-S649. doi: 10.1016/j.jcot.2020.05.016. Epub 2020 May 20.
PURPOSE
Choi IV sequela is one of the most severe outcomes of septic hips. We undertook a retrospective chart review of 15 such hips in 13 patients to identify factors contributing to the formation of this sequelae.
METHODS
The study specifically focused on patient demographics (patient's age; time to arthrotomy from initial symptoms; causative organism; post arthrotomy duration when Choi IV changes were obvious) and radiological findings at the time of arthrotomy.
RESULTS
The average patient's age at time of infection was 2.9 years. Five children were infants. The time to arthrotomy from initial symptoms was mean 21.6 days. Multifocal involvement was seen in 2 patients. Concurrent arthritis and osteomyelitis was present in 8 (53%) and pathological subluxation or dislocation in 9 hips (60%). Methicillin-sensitive Staphylococcus aureus was isolated in 7 and Methicillin-resistant Staphylococcus aureus in 4 patients. The Choi IV findings were established on average 3.8 months post arthrotomy.
CONCLUSIONS
Delay in treatment, post septic dislocation and concurrent femoral osteomyelitis were factors associated with Choi IV septic sequelae. The pathology occurred irrespective of age.
目的
Choi IV 后遗症是化脓性髋关节炎最严重的后果之一。我们对13例患者的15个此类髋关节进行了回顾性病历审查，以确定导致这种后遗症形成的因素。
方法
该研究特别关注患者人口统计学特征（患者年龄；从初始症状到关节切开术的时间；致病微生物；Choi IV变化明显时关节切开术后的持续时间）以及关节切开术时的放射学表现。
结果
感染时患者的平均年龄为2.9岁。5名儿童为婴儿。从初始症状到关节切开术的时间平均为21.6天。2例患者出现多灶性受累。8例（53%）存在并发关节炎和骨髓炎，9个髋关节（60%）存在病理性半脱位或脱位。7例患者分离出对甲氧西林敏感的金黄色葡萄球菌，4例患者分离出耐甲氧西林金黄色葡萄球菌。Choi IV表现平均在关节切开术后3.8个月出现。
结论
治疗延迟、化脓后脱位和并发股骨骨髓炎是与Choi IV化脓性后遗症相关的因素。无论年龄大小都会出现这种病理情况。
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