Szypryt E P, Clement D A, Colton C L
Queen's Medical Centre, University Hospital, Nottingham, England.
J Bone Joint Surg Br. 1987 Nov;69(5):737-42. doi: 10.1302/0301-620X.69B5.3680334.
Forty-eight consecutive patients (53 hips) were treated for moderate or severe slips of the upper femoral epiphysis between 1974 and 1984; 46 patients (96%) returned for clinical and radiological assessment at a mean of five years after operation. Twenty-three patients (23 hips) underwent a Dunn's open reduction and 25 patients (30 hips) were treated by epiphysiodesis and surgical osteoplasty as advocated by Heyman and Herndon. The results of the two methods of treatment are compared. Analysis revealed that 11 hips with moderate slip (30 degrees to 50 degrees) treated by the Heyman-Herndon procedure did significantly better than the 18 hips with severe slip (greater than 50 degrees) treated by the same method. Furthermore, when these hips with severe slip were compared to the hips treated by Dunn's open reduction, all of which were displaced greater than 50 degrees, the latter fared significantly better. The authors conclude that the Heyman-Herndon procedure gave consistently good results for moderate slips, but Dunn's open reduction gave better results for hips with severe slips.
1974年至1984年间，连续48例患者（53髋）接受了中度或重度股骨近端骨骺滑脱的治疗；46例患者（96%）在术后平均五年时返回进行临床和影像学评估。23例患者（23髋）接受了邓恩（Dunn）开放式复位，25例患者（30髋）按照海曼（Heyman）和赫恩登（Herndon）倡导的方法接受了骨骺固定术和手术截骨成形术。对这两种治疗方法的结果进行了比较。分析显示，采用海曼-赫恩登手术治疗的11例中度滑脱（30度至50度）的髋关节，其效果明显优于采用相同方法治疗的18例重度滑脱（大于50度）的髋关节。此外，将这些重度滑脱的髋关节与采用邓恩开放式复位治疗的髋关节（所有这些髋关节的移位均大于50度）进行比较时，后者的效果明显更好。作者得出结论，海曼-赫恩登手术对于中度滑脱始终能取得良好效果，但邓恩开放式复位对于重度滑脱的髋关节效果更佳。
