Klemme W R, James P, Skinner S R
Department of Surgery, Walter Reed Army Medical Center, Washington, DC 20307, USA.
J Pediatr Orthop. 1998 Sep-Oct;18(5):648-50. doi: 10.1097/00004694-199809000-00018.
A retrospective study was conducted to examine the efficacy and potential morbidity of hip fusion using the Cobra-head plate in adolescents. A heterogeneous group of 11 adolescents, with recalcitrant hip pain and an average age of 14.6 years, underwent unilateral hip arthrodesis with the Cobra-head plate for internal fixation. Seven (64%) patients achieved an uneventful clinical and radiographic arthrodesis after a mean postoperative interval of 7.4 months. Four index operations (36%) were complicated by pseudarthrosis. All patients who developed a postoperative pseudarthrosis ranked at or above the 90th percentile for their age-determined weight. The relationship between the percentile-weight-for-age and the incidence of pseudarthrosis was statistically significant (p < or = 0.001). Hip-arthrodesis procedures with the Cobra-head plate in adolescents at or above the 90th percentile weight-for-age are associated with an unacceptably high rate of pseudarthrosis. In this subset of patients, alternate or supplementary stabilization methods should be considered.
进行了一项回顾性研究，以检查在青少年中使用蛇头钢板进行髋关节融合术的疗效和潜在发病率。11名青少年组成的异质性群体，患有顽固性髋关节疼痛，平均年龄为14.6岁，接受了使用蛇头钢板进行内固定的单侧髋关节融合术。7例（64%）患者在平均术后7.4个月后实现了临床和影像学上的顺利融合。4例初次手术（36%）出现了假关节并发症。所有发生术后假关节的患者其年龄对应的体重均处于或高于第90百分位数。年龄对应的体重百分位数与假关节发生率之间的关系具有统计学意义（p≤0.001）。对于年龄对应的体重处于或高于第90百分位数的青少年，使用蛇头钢板进行髋关节融合术会导致不可接受的高假关节发生率。在这部分患者中，应考虑采用替代或辅助稳定方法。
