中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2008年
8期
706-710
,共5页
股骨颈%骨折%儿童%股骨头缺血性坏死
股骨頸%骨摺%兒童%股骨頭缺血性壞死
고골경%골절%인동%고골두결혈성배사
Femoral neck%Fractures%Child%Avascular necrosis of femur head
目的 探讨儿奄股骨颈骨折后股骨头缺血性坏死的影响因素.方法 回顾1994年6月至2006年4月收治的33例儿童股骨颈骨折患者资料,其中Delbet Ⅰ型1例、Ⅱ型15例、Ⅲ型14例、Ⅳ型2例.平均受伤年龄10.7岁(3.7-14.1岁).所有患儿均随访至骨折愈合后,平均随访时间为3.4年(1.0-12.2年).16例发生股骨头缺血性坏死,其中Ratliff Ⅰ型犁8例、Ⅱ型3例、Ⅲ璎4例、分型不详1例.将受伤年龄、骨折类型、骨折移位程度、复位质量及内固定物类型等影响凶素分别与股骨头缺血性坏死进行计算和统计分析.结果年龄＜10岁组(11例)有4例、年龄≥10岁组(22例)有12例发生股骨头缺血性坏死(P=0.465).骨折Delbet Ⅱ型组(15例)有8例、Ⅲ型组(14例)有6例发生股骨头缺血性坏死,发生率比较差异无统计学意义(P=0.715).无移位骨折组(4例)有1例、移位骨折组(26例)有14例发生股骨头缺血性坏死,发牛率比较差异无统计学意义(P=0.598).复位满意组(20例)有10例、复位不满意组(9例)有6例发生股骨头缺血性坏死,发生率比较差异无统计学意义(P=0.454).非坚强内固定组(27例)有13例、坚强内固定组(4例)有2例发生股骨头缺血性坏死,发牛率比较差异无统计学意义(P=1.000).结论 骨折类型、骨折移位程度、复位质量及受伤年龄等因素均可以影响儿童股骨颈骨折后股骨头缺血性坏死的发牛率.
目的 探討兒奄股骨頸骨摺後股骨頭缺血性壞死的影響因素.方法 迴顧1994年6月至2006年4月收治的33例兒童股骨頸骨摺患者資料,其中Delbet Ⅰ型1例、Ⅱ型15例、Ⅲ型14例、Ⅳ型2例.平均受傷年齡10.7歲(3.7-14.1歲).所有患兒均隨訪至骨摺愈閤後,平均隨訪時間為3.4年(1.0-12.2年).16例髮生股骨頭缺血性壞死,其中Ratliff Ⅰ型犛8例、Ⅱ型3例、Ⅲ瓔4例、分型不詳1例.將受傷年齡、骨摺類型、骨摺移位程度、複位質量及內固定物類型等影響兇素分彆與股骨頭缺血性壞死進行計算和統計分析.結果年齡＜10歲組(11例)有4例、年齡≥10歲組(22例)有12例髮生股骨頭缺血性壞死(P=0.465).骨摺Delbet Ⅱ型組(15例)有8例、Ⅲ型組(14例)有6例髮生股骨頭缺血性壞死,髮生率比較差異無統計學意義(P=0.715).無移位骨摺組(4例)有1例、移位骨摺組(26例)有14例髮生股骨頭缺血性壞死,髮牛率比較差異無統計學意義(P=0.598).複位滿意組(20例)有10例、複位不滿意組(9例)有6例髮生股骨頭缺血性壞死,髮生率比較差異無統計學意義(P=0.454).非堅彊內固定組(27例)有13例、堅彊內固定組(4例)有2例髮生股骨頭缺血性壞死,髮牛率比較差異無統計學意義(P=1.000).結論 骨摺類型、骨摺移位程度、複位質量及受傷年齡等因素均可以影響兒童股骨頸骨摺後股骨頭缺血性壞死的髮牛率.
목적 탐토인엄고골경골절후고골두결혈성배사적영향인소.방법 회고1994년6월지2006년4월수치적33례인동고골경골절환자자료,기중Delbet Ⅰ형1례、Ⅱ형15례、Ⅲ형14례、Ⅳ형2례.평균수상년령10.7세(3.7-14.1세).소유환인균수방지골절유합후,평균수방시간위3.4년(1.0-12.2년).16례발생고골두결혈성배사,기중Ratliff Ⅰ형리8례、Ⅱ형3례、Ⅲ영4례、분형불상1례.장수상년령、골절류형、골절이위정도、복위질량급내고정물류형등영향흉소분별여고골두결혈성배사진행계산화통계분석.결과년령＜10세조(11례)유4례、년령≥10세조(22례)유12례발생고골두결혈성배사(P=0.465).골절Delbet Ⅱ형조(15례)유8례、Ⅲ형조(14례)유6례발생고골두결혈성배사,발생솔비교차이무통계학의의(P=0.715).무이위골절조(4례)유1례、이위골절조(26례)유14례발생고골두결혈성배사,발우솔비교차이무통계학의의(P=0.598).복위만의조(20례)유10례、복위불만의조(9례)유6례발생고골두결혈성배사,발생솔비교차이무통계학의의(P=0.454).비견강내고정조(27례)유13례、견강내고정조(4례)유2례발생고골두결혈성배사,발우솔비교차이무통계학의의(P=1.000).결론 골절류형、골절이위정도、복위질량급수상년령등인소균가이영향인동고골경골절후고골두결혈성배사적발우솔.
Objecfive To identify what factors contribute to the occurrence of avascular necrosis (AVN) of the femoral head after pediatric femoral neck fractures. Methods A series of 33 pediatric femoral neck fractures who had been admitted to our institution between June 1994 and April 2006 were retrospectively reviewed. There were 1 case of type Ⅰ,15 type Ⅱ,14 type Ⅲ and 2 type IV according to Delbet classification. The mean age at injury was 10.7(3.7 to 14.1) years, and the mean follow-up was 3.4(1 to 12.2)years. All patients were followed up until union was achieved. AVN occurred in 16 cases, including 8 cases of Ratliff type Ⅰ,3 of Ratliff type Ⅱ,4 of Ratliff type Ⅲ and 1 unclassified. Age at injury, fracture type, degree of displacement, quality of reduction and type of fixation were calculated and analyzed with respect to AVN. Results AVN occurred in 4 cases (36.4%)under 10 years old and in 12 cases (54.5%)10 years old or more. Eight cases (53.3%)of AVN occurred in Delbet type Ⅱ and 6 cases (42.9%) of AVN occurred in type Ⅲ.One case (25.0%)of AVN occurred in non-displaced group and 14 cases(53.8%)in displaced group. Ten cases(50.O%)of AVN occurred in the group whose reduction quality was satisfactory and 6 cases(66.7%)in unsatisfactory reduction group. Thirteen cases (48.1%)of AVN occurred in the unstable fixation group and 2 cases (50.0%)in the stable fixation group. Conclusion Fracture type, degree of displacement, quality of reduction and age at injury can affect the occurrence of AVN of the femoral head after pediatric femoral neck fractures.
