Çağlar Ceyhun, Akçaalan Serhat, Bozer Merve, Akkaya Mustafa
Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey.
Department of Orthopedics and Traumatology, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
Hip Pelvis. 2022 Dec;34(4):245-254. doi: 10.5371/hp.2022.34.4.245. Epub 2022 Dec 3.
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).
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).
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.
Surgery performed on adolescent patients using an adult PHLP showed good, safe results. Therefore, it should be considered as an alternative option.
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。
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。
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°。
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。