Scheerlinck T, De Boeck H
Department of Orthopaedic Surgery and Traumatology, Academic Hospital V.U.B., Brussels, Belgium.
J Pediatr Orthop B. 1998 Jul;7(3):246-8. doi: 10.1097/01202412-199807000-00015.
Stress fractures of the femoral neck with an open capital femoral epiphysis in children are very rare. Up to the time of this writing, 12 cases have been described in children between the ages of 5 and 16 years (2, 4, 10-12, 14). The differential diagnosis from other hip diseases causing pain, a limp, and limited movement can be difficult when standard radiographs are normal. In this situation, tomography, isotope bone scanning, and magnetic resonance imaging (MRI) have proved to be very useful in both adults and children (2, 3, 5-8, 10-12). Complications such as nonunion or severe displacement are uncommon in children and have occurred only after they have resumed or continued the causal activity (12). As far as we are aware, bilateral development of a fatigue fracture of the femoral neck in a child has never been reported. We describe the case of an 8-year-old girl who sustained first a right then later a left femoral neck stress fracture. Displacement of the left fracture occurred after a minor but significant injury and required surgical treatment.
儿童股骨颈应力性骨折合并股骨头骨骺开放的情况极为罕见。截至撰写本文时，已报道了12例年龄在5至16岁之间的儿童病例（2、4、10 - 12、14）。当标准X线片正常时，与其他导致疼痛、跛行和活动受限的髋部疾病进行鉴别诊断可能会很困难。在这种情况下，断层扫描、同位素骨扫描和磁共振成像（MRI）已被证明在成人和儿童中都非常有用（2、3、5 - 8、10 - 12）。不愈合或严重移位等并发症在儿童中并不常见，且仅在他们恢复或继续导致骨折的活动后才会发生（12）。据我们所知，儿童双侧股骨颈疲劳骨折的情况从未被报道过。我们描述了一名8岁女孩的病例，她先是右侧，后来左侧股骨颈发生应力性骨折。左侧骨折在一次轻微但严重的损伤后发生移位，需要手术治疗。
