Fibular osteosynthesis for delayed type II and type III femoral neck fractures in children.
Fibular osteosynthesis for delayed type II and type III femoral neck fractures in children.
复制标题
DOI：
10.1097/00005131-199209000-00007
复制
发表时间：
1992-01-01
影响因子：
2.3
通讯作者：
Gill, S S
中科院分区：
文献类型：
--
作者：
Nagi, O N;Dhillon, M S;Gill, S S
采用游离腓骨移植和松质拉力螺钉治疗 17 例儿童经颈/基底股骨颈骨折。 2 例因先前手术失败，15 例已 3 周或更长时间未接受治疗。 4例术前有放射学证据显示头部和1例颈部缺血性坏死； 5例出现颈部吸收。术后平均 48.1 个月，所有骨折均已愈合，仅出现 1 例新发缺血性坏死病例。 4例有髋内翻，4例有骨骺过早闭合。根据 Ratliff 的标准，有 13 个结果良好，3 个结果一般，1 个结果较差。对于初次出现延迟或先前手术失败的病例，我们建议进行此手术。手术并发症如长螺钉/移植物和腓骨骨折是可以预防的。通过在手术中添加转子下截骨术，可以减少颈部吸收病例中髋内翻的发生率。
Seventeen transcervical/basal femoral neck fractures in children were treated by free fibular graft and cancellous lag screw. Two cases were failures of a previous surgery, and 15 had been untreated for 3 weeks or more. Four cases had radiological evidence of avascular necrosis of the head and one of the neck preoperatively; five cases had neck resorption. At an average of 48.1 months postsurgery all fractures had united and there was only one new case of avascular necrosis. Four cases had coxa vara, and four cases had premature epiphyseal closure. There were 13 good, three fair, and one poor result(s) using Ratliff's criteria. We recommend this procedure in cases with delayed initial appearance or failed previous surgery. Complications of the procedure such as long screw/graft and fibular fracture are preventable. The incidence of coxa vara in cases with neck resorption may be reduced by adding subtrochanteric osteotomy to the procedure.