儿童股骨颈骨折的治疗

目的　探讨如何提高儿童股骨颈骨折治疗效果及降低其并发症。方法　在 2 1例儿童股骨颈骨折病例中 ,对无移位者采用髋人字石膏固定 ,对移位者采用手法复位经皮多枚克氏针内固定 ,对手法复位失败者采用手术切开复位 ,空心螺丝钉内固定 ,对伤后 36小时入院者均行髋关节减压。结果　本组 17例经 1～ 13年的随访 ,其中 ,骨折无移位者无明显并发症 ;骨折有移位者中 ,股骨头缺血性坏死 2例 ,髋内翻 2例 ,股骨颈缩短大粗隆明显上移 2例。行关节穿刺减压后再行固定治疗的 5例无明显并发症。结论　儿童股骨颈骨折较少见 ,但并发症发生率高 ,采用早期关节穿刺减压 ,及时准确复位 ,坚强的内外固定 ,是减少并发症的重要措施

Treatment of femoral neck fracture in children

Objective To improve the treatment of femoral neck fracture in children and reduce its rate of complications.?Methods From 1987 to 2000,21 children with femoral neck fracture were treated in our hospital,in those cases ones without displacement were immobilized with plaster inposition,and the ones with displacement received manipulative reduction and immobilized with 3 K wires fixed by transcutaneous route,those cases that failed in maniputative reduction received the open reduction and immobilized by hollow screw. Some children who were hospitalized 36 hours after injury were treated by hip joint decompression.?Results Seventeen children were followed up 1 to 13 years respectively. No complication occurred in the children without displacement,while in the children with displacement,2 cases had ischemic necrosis in femoral head,2 cases showed coxa varus and 2 cases had shortened femoral neck with distinct overgrowth of greater trochanter. The 5 cases who received decompression did no show any complication.?Conclusion Femoral neck fracture in children is rare, but often leads to some complications. Decompression by puncture in hip,exact reduction in time and firmly immobilization are important to avoid the complications.