[1]卢虹旭　李　明　刘　星　刘传康　罗　聪曹豫江　瞿向阳　翁刘其　周　海　郑　超.可吸收棒内固定在儿童Ｐｅｒｔｈｅｓ病骨盆三联截骨术治疗中的应用[J].临床小儿外科杂志,2018,17(01):29-33.
　Lu Hongxu,Li Ming,Liu Xing,et al.The internal fixation of absorbable rods for pelvic triple osteotomy in children Perthes disease.[J].Journal of Clinical Pediatric Surgery,2018,17(01):29-33.
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可吸收棒内固定在儿童Ｐｅｒｔｈｅｓ病骨盆三联截骨术治疗中的应用

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第17卷 期数: 2018年01期 页码: 29-33 栏目: 论著 出版日期: 2018-01-28
Title:
The internal fixation of absorbable rods for pelvic triple osteotomy in children Perthes disease.
作者:
卢虹旭　李　明　刘　星　刘传康　罗　聪曹豫江　瞿向阳　翁刘其　周　海　郑　超
重庆医科大学附属儿童医院骨科中心
Author(s):
Lu Hongxu; Li Ming; Liu Xing; Liu Chuankang; Luo Cong; Cao Yujiang; Qu Xiangyang; Weng Liuqi; Zhou Hai; Zheng Chao.
Orthopedic Center of Childrens Hospital of Chongqing Medical University,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing International Science and Technology Cooperation Center for Child Development and Disorders,Chongqing,400014,China.
关键词:
Ｐｅｒｔｈｅｓ病; 三联截骨; 内固定; 可吸收棒; 儿童
Keywords:
LeggPerthes Disease;  Triple osteotomy;  Internal fixation;  Absorbable rod;  Child
文献标志码:
A
摘要:
目的　评估儿童Ｐｅｒｔｈｅｓ病骨盆三联截骨术中应用可吸收棒内固定治疗的可行性、疗效
及优势。　方法　收集２００７年４月至２０１４年１２月间由本院收治的７４例（７９髋）儿童Ｐｅｒｔｈｅｓ病的患
儿，按Ｃａｔｔｅｒａｌｌ分型：Ⅲ型５９髋，Ⅳ型２０髋，均采用ＰｏｌＬｅＣｏｅｕｒ骨盆三联截骨联合可吸收棒内固定术
治疗。　结果　术后随访１４个月至７年９个月（平均４６个月），根据Ｍｃｋａｙ标准，本组病例术后髋关节
功能优５１例（５３髋），良１５例（１７髋），可８例（９髋），优良率为８８．６１％。术后随访Ｘ线片显示骨盆截
骨植骨处固定良好，无植骨块松动移位及骨吸收病例发生。患髋髋臼覆盖率由术前７５．０６％的平均值
增加至术后的９５．７０％，差异有统计学意义（ｔ＝－３２．０６，Ｐ＜０．００１）；术前患髋骺高比平均为６５．４９％，
术后平均为８０．８６％，差异有统计学意义（ｔ＝－４８．１３，Ｐ＜０．００１）；ＣＥ角由术前平均１６．２２°增加至
３４．４７°，差异有统计学意义（ｔ＝－４４．５８，Ｐ＜０．００１）；而Ｓｈａｒｐ角则由术前的４１．４６°降至术后的２４．１６°，
差异有统计学意义（ｔ＝５１．４４，Ｐ＜０．００１）。　结论　可吸收棒代替克氏针或金属螺钉应用于儿童
Ｐｅｒｔｈｅｓ病三联截骨术中髂骨截骨处的固定，疗效满意，操作简单，固定牢靠，无明显不良反应，可避免二
次手术创伤。
Abstract:
ObjectiveTo evaluate the feasibility,efficacy and advantage of triple pelvic osteotomy with absorbable rods fixation for the treatment of Perthes disease.MethodsFrom April 2007 to December 2014,74 cases of Perthes disease(79 hips) were collected in this study.According to Catteralls classification,there were 59 hips of grade Ⅲ and 20 hips of grade Ⅳ.All patients were treated by Pol Le Coeurs triple osteotomy with self-reinforced absorbable (SRPLLA) rods fixation at iliac osteotomy sites.ResultsAll cases were followed up for 14 months to 93 months,with an average of 46 months.According to the criteria of Mckay for the diseases functional prognosis,there were 51 cases with excellent hip function,15 cases with good hip function and 8 cases with fair hip function,the “excellent” and “good” rate reached up to 88.61%.Radiographic images revealed that all osteotomy bones were healed without loosening of fixation,acetabular fragment migration,iliac bone grafts osteolysis or dislocation.The percentage coverage of the femoral head improved from average 75.06% before operation to 95.70% at final follow-up(t=-32.06，P＜0.001).The average epiphyseal height ratio was 65.49% before operation,and it was 80.86% at final review(t=-48.13，P＜0.001).The initial CE angle was 16.22°,which finally increased to 34.47°(t=-44.58，P＜0.001).The average Sharpangle was decreased from 41.46° before surgery to 24.16° after operation(t=51.44，P＜0.001).ConclusionAbsorbable rods instead of kirschner wires or screws used for fixing osteotomy sites in triple pelvic osteotomy is a simple,reliable and effective way to treat cutting pelvis and iliac bone grafts in Perthes disease.The operation did not receive obvious adverse reactions and can surely avoid the secondary removal operation.
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