电邮这篇文章 青年早期股骨头骨骺松解症儿童股骨近端骨骺固定的若干问题
- 作者: Barsukov D.B.1, Bortulev P.I.1, Baskov V.E.1, Pozdnikin I.Y.1, Murashko T.V.1, Baskaeva T.V.1
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隶属关系:
- H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
- 期: 卷 9, 编号 3 (2021)
- 页面: 277-286
- 栏目: Original Study Article
- ##submission.dateSubmitted##: 06.07.2021
- ##submission.dateAccepted##: 24.08.2021
- ##submission.datePublished##: 04.10.2021
- URL: https://journals.eco-vector.com/turner/article/view/75677
- DOI: https://doi.org/10.17816/PTORS75677
- ID: 75677
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详细
论证。在使用自体或同种异体移植物以及合成植入物进行股骨头骨骺固定术的青少年骨骺松解术的早期阶段后，注意到受影响关节的股骨组件畸形，导致股骨-髋臼凸轮型撞击和臀肌功能障碍。大多数外科医生放弃了这种干预，转而使用现代金属结构in situ固定松果体，特别是带有近端螺纹的空心螺钉。关于提供稳定固定的螺钉数量以及如何减少它们对股骨软骨生长的负面影响的问题仍然存在争议。
目的是提高早期儿童股骨头骨骺的手术治疗效果。
材料与方法。对40例11～14岁青少年股骨头骨骺一期I期、另一关节II期患者40例（80个受累关节）的影像学检查结果进行分析。确定了两组20名儿童，其中每组松果体都用一个直径7.0毫米的空心螺钉固定，而第一组螺钉头靠在皮质层上，第二组则用5-10毫米。17-18岁时评估长期结果，此时股骨近端没有软骨和软骨生长的迹象。对所得数据进行统计处理。
结果。松果体固定在所有80个关节中均稳定。到股骨生长完成时，大多数患者的II期关节中的骨骺端形状没有改变，但在32.5%的病例中记录到的改善更常见于第二组。所有40个I期关节的骨骺形态保持正常。无论干预期间病理过程处于哪个阶段，第二组在生长完成时的骨骺平均长度均大于第一组。
结论。所考虑的股骨近端骨骺固定方法，不包括带近端螺纹的空心螺钉对骨骺生长软骨的压缩作用，在幼年股骨头骨骺早期提供可靠的骨骺保留，对股关节软骨内生长的负面影响较小。
全文:
作者简介
Dmitriy Barsukov
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
编辑信件的主要联系方式.
Email: dbbarsukov@gmail.com
ORCID iD: 0000-0002-9084-5634
SPIN 代码: 2454-6548
MD, PhD
俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603Pavel Bortulev
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: pavel.bortulev@yandex.ru
ORCID iD: 0000-0003-4931-2817
SPIN 代码: 9903-6861
MD, PhD
俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603Vladimir Baskov
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: dr.baskov@mail.ru
ORCID iD: 0000-0003-0647-412X
SPIN 代码: 1071-4570
MD, PhD
俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603Ivan Pozdnikin
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: pozdnikin@gmail.com
ORCID iD: 0000-0002-7026-1586
SPIN 代码: 3744-8613
MD, PhD
俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603Tatyana Murashko
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: popova332@mail.ru
ORCID iD: 0000-0002-0596-3741
SPIN 代码: 9295-6453
MD, radiologist
俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603Tamila Baskaeva
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: tamila-baskaeva@mail.ru
ORCID iD: 0000-0001-9865-2434
SPIN 代码: 5487-4230
MD, orthopedic and trauma surgeon
俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603参考
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图 1 11年2个月术后M.患者的前后投影(a)和Lauenstein投影(b)中左髋关节的X光片。释文
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图 2 13年9个月术后M.患者的前后投影(a)和Lauenstein投影(b)中左髋关节的X光片。释文
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图 3 13年11个月术后M.患者的前后投影(a)和Lauenstein投影(b)中左髋关节的X光片。释文
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图 4 在计算机断层摄影上测量股骨近端干骺端长度的方法。释文
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图 5 患者B.左髋关节的前后位和劳恩斯坦X光片13年5个月，手术前(a，b)，手术后立即(c)2年后1个月。手术后（d，e）。释文
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