Canale S T, Bourland W L
J Bone Joint Surg Am. 1977 Jun;59(4):431-43.
End-result evaluations after an average follow-up of seventeen years are reported in sixty-one cases (sixty patients). There were five Type-1 (transepiphyseal), twenty-seven Type-II (transcervical), twenty-two Type-III (cervicotrochanteric), and seven Type-IV (intertrochanteric) femoral fractures. The majority of Type-I, Type-II, and displaced Type-III fractures were treated with closed or open reduction and Knowles-pin fixation. The majority of undisplaced Type-III and Type-IV fractures were treated with abduction plaster spica casts. Fifty-five per cent were found to have good resultswhile 20% were fair and 25%, poor. The incidence of complications--avascular necrosis, coxa vara, premature epiphyseal closure, infection, and non-union--was compared with that in previously reported series. The use of Knowles-pin fixation appeared to reduce the complications of non-union and coxa vara. Avascular necrosis caused most of the poor results. However, younger children with avascular necrosis obtained better results than did older ones. Some children with results graded as poor roentgenographically were only mildly symptomatic.
报告了61例（60名患者）平均随访17年后的最终结果评估情况。有5例I型（经骨骺）、27例II型（经颈）、22例III型（颈转子间）和7例IV型（转子间）股骨骨折。大多数I型、II型和移位的III型骨折采用闭合或切开复位及诺尔斯针固定治疗。大多数无移位的III型和IV型骨折采用外展髋人字石膏固定治疗。发现55%的患者效果良好，20%的患者效果一般，25%的患者效果差。将并发症——缺血性坏死、髋内翻、骨骺过早闭合、感染和骨不连——的发生率与先前报道的系列进行了比较。使用诺尔斯针固定似乎可减少骨不连和髋内翻的并发症。缺血性坏死导致了大多数不良结果。然而，患有缺血性坏死的年幼儿童比年长儿童的结果更好。一些X线检查结果分级为差的儿童仅表现为轻度症状。
