儿童股骨头缺血后畸形的外科治疗途径：文献综述

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儿童股骨头缺血后畸形多由Legg–Calvé–Perthes病及股骨头缺血性坏死所致，可导致髋关节解剖与功能障碍，并引起早发性髋关节骨关节炎。治疗方法和手术时机的选择问题在当前仍具现实意义。本文对国内外有关儿童股骨头缺血后畸形外科治疗的科学文献进行了分析，旨在系统梳理现有手术方法，评估其疗效，并探讨其在儿童骨科中的发展前景.本文呈现了在PubMed、Cochrane和eLibrary数据库中的检索结果。在共获得的64篇文献中（2000–2023年，俄文28篇，英文36篇），有48篇涉及该类畸形的手术治疗.关节外手术在矫正缺血后畸形方面显示出中期疗效，但可能导致并发症，如骨骺生长板和大转子骺板的早闭，从而引起关节面相容性的下降。近年来，伴随外科髋关节脱位的关节内手术已得到广泛应用。该方法能够在术中直接评估股骨头的状况、形态和结构，从而最大限度地实现其解剖学修复。研究结果表明，在儿童髋关节不同疾病类型下，股骨头多平面畸形若治疗不及时或不恰当，将导致关节功能的持续丧失，并造成患者的早期致残。文献分析表明，关节内手术在治疗儿童股骨头缺血后畸形方面可能具有一定疗效。然而，要更加客观地评价其对疾病后续进展的影响，还需要对治疗的远期结果进行分析。

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作者简介

Mikhail V. Zabaluev

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

编辑信件的主要联系方式.
Email: zabaluevmishka@yandex.ru
ORCID iD: 0009-0003-9497-7305
SPIN 代码: 7100-0993

MD

俄罗斯联邦, Saint Petersburg

Sergey V. Vissarionov

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: vissarionovs@gmail.com
ORCID iD: 0000-0003-4235-5048
SPIN 代码: 7125-4930

MD, Dr. Sci. (Medicine), Professor, Corresponding Member of RAS

俄罗斯联邦, Saint Petersburg

Ivan Yu. Pozdnikin

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: pozdnikin@gmail.com
ORCID iD: 0000-0002-7026-1586
SPIN 代码: 3744-8613

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg

Dmitrii B. Barsukov

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: dbbarsukov@gmail.com
ORCID iD: 0000-0002-9084-5634
SPIN 代码: 2454-6548

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg

Tamila V. Baskaeva

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: tamila-baskaeva@mail.ru
ORCID iD: 0000-0001-9865-2434
SPIN 代码: 5487-4230

MD

俄罗斯联邦, Saint Petersburg

Pavel I. Bortulev

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: pavel.bortulev@yandex.ru
ORCID iD: 0000-0003-4931-2817
SPIN 代码: 9903-6861

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg

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