Guillozet N
Clin Pediatr (Phila). 1981 Jan;20(1):19-23. doi: 10.1177/000992288102000102.
Aseptic necrosis of the capital femoral epiphysis occurred in a polio-wasted leg and was undiagnosed for over one year. The diagnosis was overlooked because of a pre-existent limp. Exacerbation of an existent limp or persistent knee or leg pain should always prompt a thorough search to exclude chronic and acute causes of hip disease in young children. Aggressive and individualized care is indicated for Perthes' disease and may include non-surgical means such as recumbency and bracing in the very young or traction with abduction and various bracings in the older children. Surgical approaches may include femoral and/or pelvic osteotomies in a variety of approaches. Older children may refuse treatment and those with milder femoral head involvement may recover with minimal head asymmetry. Early and appropriate management is generally successful in avoiding deformity.
一名小儿麻痹后遗症导致腿部肌肉萎缩的患者发生了股骨头骨骺无菌性坏死，且一年多未被诊断出来。由于之前就存在跛行，该诊断被忽视了。对于幼儿，现有跛行加重或持续的膝关节或腿部疼痛应始终促使进行全面检查，以排除髋部疾病的慢性和急性病因。针对佩特兹病需要积极且个性化的治疗，对于幼儿可能包括非手术方法，如卧床休息和支具固定，对于年龄较大的儿童则可能包括外展牵引和各种支具固定。手术方法可能包括多种入路的股骨和/或骨盆截骨术。年龄较大的儿童可能拒绝治疗，而股骨头受累较轻的儿童可能以最小的头部不对称恢复。早期且适当的治疗通常能成功避免畸形。
