Chang C H, Huang S C
Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, ROC.
J Formos Med Assoc. 1997 May;96(5):353-8.
Sequelae of septic hip in children may develop either due to inadequate management or neglect in the acute stage. We treated 13 patients (13 hips) with late sequelae of septic hip by reconstruction procedures, from 1985 to 1992. The mean age of the patients was 6.1 years. Their initial bony deformities were all beyond Hunka's classification type IIB. All of them had problems of hip instability and leg length discrepancy. With the intention to reestablish containment of the hip joint, open reduction, femoral osteotomy and pelvic osteotomy were performed. Four patients, all beyond Hunka type IV, had secondary surgery for hip resubluxation. Leg length discrepancies were corrected by valgus osteotomy and limb lengthening. At an average follow-up of 6.3 years, all remodeled hips were stable. Early reconstruction is recommended to stabilize the hip joint and restore the normal hip center for bone development. The leg length discrepancies were corrected by an Ilizarov limb lengthening procedure at a later stage.
儿童化脓性髋关节炎的后遗症可能是由于急性期治疗不当或被忽视所致。1985年至1992年期间,我们采用重建手术治疗了13例(13髋)化脓性髋关节炎晚期后遗症患者。患者的平均年龄为6.1岁。他们最初的骨骼畸形均超过洪卡(Hunka)分类的IIB型。所有患者均存在髋关节不稳定和肢体长度不等的问题。为了重新建立髋关节的包容,我们进行了切开复位、股骨截骨术和骨盆截骨术。4例均超过洪卡IV型的患者因髋关节再半脱位接受了二次手术。通过外翻截骨术和肢体延长术纠正了肢体长度不等的问题。平均随访6.3年时,所有重塑的髋关节均稳定。建议早期进行重建以稳定髋关节并恢复正常的髋关节中心,以促进骨骼发育。后期通过伊里扎洛夫(Ilizarov)肢体延长手术纠正肢体长度不等的问题。