Salter骨盆截骨治疗LeggPerthes病远期结果观察.docVIP

Salter骨盆截骨治疗LeggPerthes病远期结果观察 　【摘要】 由于儿童LeggPerthes病是一种自限性疾病，是否需要 治疗 和如何治疗在国内学者之间还存在分歧。作者曾经 应用 Salter骨盆截骨的 方法 治疗儿童LeggPerthes病，本文旨在探讨手术治疗的病例在骨骼发育成熟后的股骨头形态、股骨头与髋臼的匹配程度，并试图从系统复习 文献 中确定手术指征和方法。［方法］对1994年以前采取Salter骨盆截骨治疗16例LeggPerthes病进行追踪观察。本组病例在手术时平均年龄为6岁7个月。其中12例获得平均10年3个月的随访，病人平均年龄17岁2个月，其股骨近端骺板和髋臼Y形软骨都已完全闭合，表明髋关节发育已经完全成熟。沿用文献上标准的Stulberg评定方法，对X线结果做出评价。［结果］本组12例中评定为Stulberg Ⅰ级4例（33％），Stulberg Ⅱ级6例（50％），Stulberg Ⅲ级1例（8％），Stulberg Ⅳ级1例（8％），没有Stulberg Ⅴ级病例。肢体平均短缩1.5 cm（0.8～2.0 cm），髋关节功能基本在正常范围之内，临床上也没有明显的步态异常。［结论］Salter骨盆截骨能够使缺血性坏死的股骨头获得满意的塑形，恢复与髋臼相匹配的解剖关系，从而有助于防止提早发生骨性关节炎。 毕业论文 【关键词】 Salter骨盆截骨 LeggPerthes病 儿童 Abstract：［Objective］To observe radiographic morphology of femoral head at skeletal maturity of the Salter innominate osteotomy for treatment of patients with LeggPerthes disease and evaluate sphericity of the femoral head and congruity of the hip.Based on system review of literatures,the authors attempted to determine the indications and methods of treatment.［Method］Sixteen patients of LeggPerthes disease were treated by Salter innominate osteotomy before 1994. The mean age of patients was six years and seven months at operation.Of them,only were 12 patients followed up 10 years and ten months avergely and mean ages of patients were 17 years and 2 months at last followup.Growth of plate of femoral head and Y cartilage of acetabulum was closed,indicating skeletal maturity.［Result］According to Stulberg classification of outcome,there were four cases in Stulberg class Ⅰ and six patient in class Ⅱ and one patient in class Ⅲ and one patients in class Ⅳ and no case in class Ⅴ.Lower limb of shortening was averagely 1.5 cm（ranged 0.8～2.0 cm）and the range of motion of hips was almost normal and no abnormal gait was observed.［Conclusion］The Salter innominate osteotomy could keep sphericity of the femoral head and congruity with acetabulum of the hip for children with LeggPerthes disease and also could be in aid of preventing premature arthritis of hip.