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成人肱骨近端锁定钢板是治疗青少年股骨转子下骨折的良好替代选择:病例系列及文献综述

Adult Proximal Humeral Locking Plate Is a Good Alternative Option in the Treatment of Adolescent Subtrochanteric Femur Fractures: A Case Series and Literature Review.

作者信息

Çağlar Ceyhun, Akçaalan Serhat, Bozer Merve, Akkaya Mustafa

机构信息

Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey.

Department of Orthopedics and Traumatology, Ankara Yıldırım Beyazıt University, Ankara, Turkey.

出版信息

Hip Pelvis. 2022 Dec;34(4):245-254. doi: 10.5371/hp.2022.34.4.245. Epub 2022 Dec 3.

DOI:10.5371/hp.2022.34.4.245
PMID:36601609
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9763829/
Abstract

PURPOSE

Management of pediatric subtrochanteric femur fractures (SFFs) is difficult. The aim of this study was to evaluate the outcomes of adolescent SFFs treated with adult proximal humeral locking plates (PHLPs).

MATERIALS AND METHODS

A retrospective analysis of 18 adolescents (11 male, 7 female) with a diagnosis of SFF who underwent internal fixation with a PHLP was conducted. Data regarding injury mechanism, fracture pattern, and time to union were recorded for all patients. In addition, a clinical and functional evaluation of patients was performed using the Harris hip score (HHS), Iowa hip score (IHS), modified Merle d'Aubigne-Postel score (MMAPS), Flynn criteria, and hip range of motion (ROM).

RESULTS

The mean age of the patients was 12.72±2.05 years (range, 10-16 years). Radiological observation was performed for evaluation of five different injury mechanisms and different fracture patterns in patients. The mean postoperative HHS was 92.27±5.61, the mean IHS was 90.88±6.46, and the mean MMAPS was 17.22±0.94. According to the Flynn criteria, excellent results were achieved in 14 cases and satisfactory results were obtained in four cases. Measurements of the patients' mean hip ROM values were as follows: 17.77±3.52° in extension, 115.27±6.74° in flexion, 43.05±3.48° in abduction, 27.50±4.28° in adduction, 42.22±4.60° in internal rotation, and 42.22±3.91° in external rotation.

CONCLUSION

Surgery performed on adolescent patients using an adult PHLP showed good, safe results. Therefore, it should be considered as an alternative option.

摘要

目的

小儿股骨转子下骨折(SFF)的治疗颇具难度。本研究旨在评估采用成人近端肱骨锁定钢板(PHLP)治疗青少年SFF的疗效。

材料与方法

对18例诊断为SFF并接受PHLP内固定治疗的青少年患者(11例男性,7例女性)进行回顾性分析。记录所有患者的损伤机制、骨折类型及愈合时间等数据。此外,采用Harris髋关节评分(HHS)、Iowa髋关节评分(IHS)、改良Merle d'Aubigne - Postel评分(MMAPS)、Flynn标准及髋关节活动范围(ROM)对患者进行临床和功能评估。

结果

患者的平均年龄为12.72±2.05岁(范围10 - 16岁)。对患者的五种不同损伤机制和不同骨折类型进行了影像学观察评估。术后HHS平均为92.27±5.61,IHS平均为90.88±6.46,MMAPS平均为17.22±0.94。根据Flynn标准,14例结果为优,4例结果为良。患者髋关节平均ROM测量值如下:伸展17.77±3.52°,屈曲115.27±6.74°,外展43.05±3.48°,内收27.50±4.28°,内旋42.22±4.60°,外旋42.22±3.91°。

结论

采用成人PHLP对青少年患者进行手术显示出良好、安全的效果。因此,应将其视为一种替代选择。

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本文引用的文献

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2
The Repair of an Acute Pathological Subtrochanteric Femur Fracture Using an Adult 3.5-mm Proximal Humerus Locking Plate in an Adolescent Patient: A Case Report.青少年患者采用成人 3.5mm 肱骨近端锁定板治疗急性病理性转子下骨折:病例报告。
JBJS Case Connect. 2020 Apr-Jun;10(2):e0491. doi: 10.2106/JBJS.CC.19.00491.
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Osteoid osteoma of calcar of femur in child: prophylactic fixation using PHILOS and excision.儿童股骨距骨样骨瘤:使用PHILOS进行预防性固定及切除
BMJ Case Rep. 2020 Jun 29;13(6):e235073. doi: 10.1136/bcr-2020-235073.
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Pediatric tibia and femur fractures in patients weighing more than 50 kg (110 lb): mini-review on current treatment options and outcome.体重超过50千克(110磅)的儿童胫骨和股骨骨折:当前治疗选择与结果的小型综述
Musculoskelet Surg. 2019 Apr;103(1):23-30. doi: 10.1007/s12306-018-0570-8. Epub 2018 Oct 11.
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Lateral shelf acetabuloplasty for severe Legg-Calvé-Perthes disease in patients older than 8 years: A mean eleven-year follow-up.8岁以上严重Legg-Calvé-Perthes病患者的外侧髋臼成形术:平均11年随访
Medicine (Baltimore). 2016 Nov;95(45):e5272. doi: 10.1097/MD.0000000000005272.
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Int Orthop. 2016 Dec;40(12):2627-2634. doi: 10.1007/s00264-016-3259-3. Epub 2016 Aug 9.
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