Loose Oliver, Fernandez F, Müller T
Orthopädie, Klinikum Stuttgart, Kriegsbergstraße 62, 70174, Stuttgart, Deutschland.
Unfallchirurgie (Heidelb). 2025 Jun;128(6):417-424. doi: 10.1007/s00113-025-01555-0. Epub 2025 Apr 2.
Posttraumatic femoral head necrosis after a femoral neck fracture in children and adolescents is a rare but severe complication. If this occurs in older patients a total hip arthroplasty (THA) is mostly indicated. In children and adolescents the primary goal of treatment is preservation of the hip joint. There is no standard treatment or generally applicable treatment recommendation. Various measures for treating this rare entity are discussed in the literature. In addition to conservative measures, retrograde drilling with or without cancellous bone grafting, joint distraction or grafting measures are available. As a final solution, however, a THA is also a suitable treatment option as soon as the anatomical conditions are appropriate.
儿童和青少年股骨颈骨折后发生创伤性股骨头坏死是一种罕见但严重的并发症。如果发生在老年患者中，大多需要进行全髋关节置换术（THA）。对于儿童和青少年，治疗的主要目标是保留髋关节。目前尚无标准治疗方法或普遍适用的治疗建议。文献中讨论了治疗这种罕见病症的各种措施。除了保守措施外，还可采用带或不带松质骨移植的逆行钻孔、关节牵张或移植措施。然而，作为最终解决方案，一旦解剖条件合适，THA也是一种合适的治疗选择。
