股骨头骨骺滑脱8例治疗体会

摘要

复习8例股骨头骨骺滑脱(SCFE)病例的临床资料和手术方法,评价其临床治疗效果.8例SCFE中5例为典型发病年龄,3例为非典型发病年龄.其中急性滑脱2例,慢性滑脱1例,慢性基础上急性滑脱5例.滑脱程度Ⅰ度1例、Ⅱ度5例、Ⅲ度2例.治疗方法:切开复位三棱针固定1例.牵引复位穿针内固定4例,持续牵引治疗2例,粗隆下截骨1例.6例牵引后,3例完全复位.3例基本复位.随访平均2年.从5例慢性基础上急性滑脱与1例急性滑脱牵引逐渐内旋复位的结果上看,复位是可能的.复位后4例穿3根克氏针内固定,2例持续牵引治疗.该治疗方法没有明显的并发症,因此临床应用是安全可靠的.本组典型的股骨头骨骺滑脱5例都发生在超重肥胖儿童.对早期稍跛、外旋步态者应给予充分重视.%Eight cases of slipped capital femoral epiphysis(SCFE)were reviewed.The onset was at vulnerable age in 5 cases and nonvulnerable age in 3.Among them,2 were acute type,1 chronic and 5 acuteon-chronic.Displacement of the femoral neck by grade Ⅰ was found in one case,Grade Ⅱ in 5 and Grade Ⅲ in 2.Open reduction and internal fixation with trifin pin were performed on 1 case:trifin nailing after traction on 4;continuous traction on 2;and subtrochanteric osteotomy on 1.Among the 6 cases of traction,total reduction was obtained in 3 and subtotal reduction in 3.The average period of follow-up was 2 years.The results in 5 cases of acute-on-chronic type and 1 case of acute type showed that a total reduction was possible.No obvious complication was found.5 cases with typical SCFE were over-weight fatty children.All attention should be paid to those with early lamping and external rotation gait.