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A mini-incision on the anterior hip for pediatric femur neck fractures of type Delbet Ⅱ

A mini-incision on the anterior hip for pediatric femur neck fractures of type Delbet Ⅱ

Zhonghua Wai Ke Za Zhi 57(2): 129-133

目的: 探讨髋关节前侧短切口切开复位内固定术治疗儿童Delbet Ⅱ型股骨颈骨折的临床效果及手术经验。 方法: 回顾性分析2014年1月至2016年8月于南京医科大学附属儿童医院骨科采用髋关节前侧短切口切开复位内固定术治疗的12例Delbet Ⅱ型股骨颈骨折患儿资料,男性7例,女性5例,年龄(11.5±0.8)岁(范围:8~14岁)。左侧8例,右侧4例,受伤至手术时间(12.0±0.9)h(范围:6~20 h)。手术切口以髂前下棘为中点,向两端沿腹股沟方向延伸,长3~4 cm;于缝匠肌与阔筋膜张肌间隙进入,拉开股直肌,暴露关节囊前方,T形切开关节囊暴露骨折并复位,使用2~3枚空心加压螺钉固定。术后定期行X线检查及临床检查判断骨折愈合时间,记录相关并发症。末次随访时根据Ratliff评分标准评价手术效果。 结果: 12例患儿均获得随访,随访时间(30.0±4.1)个月(范围:24~36个月)。患者X线片均显示骨折愈合,愈合时间为(8.0±0.4)周(范围:7~9周)。其中2例患儿发生Ratliff Ⅱ型股骨头缺血性坏死,1例患儿发生骺早闭,无骨折再移位、髋内翻、延迟愈合、骨不连等,无切口感染、螺钉松动、断裂等并发症发生。Ratliff评分:良9例(9/12)、可3例(3/12)、差0例。 结论: 髋关节前侧短切口入路切开复位内固定治疗儿童Delbet Ⅱ型股骨颈骨折,近期临床效果满意,具有创伤小、美观、复位固定可靠、切口并发症少等优势。.

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Accession: 066446336

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PMID: 30704217

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