LCPD特发性儿童股骨头坏死：Legg-Calvé-Perthes病去旋转股骨内翻截骨术的长期结果

LCPD特发性儿童股骨头坏死：Legg-Calvé-Perthes病去旋转股骨内翻截骨术的长期结果：26年随访

作者：Peter Than, Vilmos Halmai, Shoaib Shaikh, János Kránicz, Arpád Bellyei.

作者单位: Department of Orthopedics, Faculty of Medicine, University of Pécs, Hungary.

译者：陶可（北京大学人民医院骨关节科）

摘要

本文介绍了30名接受去旋转股骨内翻截骨术治疗Legg-Calvé-Perthes病的患者（31个髋关节）的长期结果。对手术髋部的疼痛、双下肢长度差异、Trendelenburg征和活动范围进行了临床检查。X线照相测量分析包括Wiberg角、骨骺指数、髋臼指数和Mose指数。发现所有患者术后恢复满意度都归于良好/一般类别。根据Catterall术后分类，31个髋关节中有27个（87%）获得了良好/一般的结果。由于活动严重受限和持续的髋关节疼痛，4名患者被归为愈后差。因此，推荐采用去旋股骨内翻截骨术来治疗Legg-Calvé-Perthes病患者。

FIGURE 1: Seven-year-old boy, left Legg-Calve-Perthes disease, clear “head at risk signs.”

图1：7岁男孩，患有Legg-Calve-Perthes病，有明显的“头部危险迹象”。

FIGURE 2: Nine months after subtrochanteric varus osteotomy with first screw through the trochanter to achieve partial apophysiodesis.

图2：股骨粗隆下内翻截骨术后9个月，第一颗螺钉穿过股骨转子以实现部分骨骺固定术。

FIGURE 3: Eighteen months postoperative, the head is regenerating, keeping roundness and good coverage, whereas the osteotomy site is remodeled, with some improvement of the neck shaft angle.

图3：术后18个月，股骨头正在再生，保持圆润度和良好的髋臼覆盖度，而截骨部位则进行了重塑，颈干角度有所改善。

Long-term results of derotational femoral varus osteotomy in Legg-Calvé-Perthes disease: 26-year follow-up

Abstract

The long-term results of 30 patients (31 hips) who underwent derotational femoral varus osteotomy for Legg-Calvé-Perthes disease are presented. Pain, leg-length discrepancy, Trendelenburg sign, and range of motion at the operated hip were examined clinically. Radiographic analysis included measurement of the Wiberg angle, epiphyseal index, acetabular index, and the Mose index. All were found to be satisfactory for patients in the good/fair category. Good/fair results were obtained in 27 (87%) of 31 hips according to Catterall‘s postoperative classification. Four patients were classified in the poor category due to severe restriction of movement and constant hip pain. Therefore, derotational femoral varus osteotomy is recommended for the treatment of patients with Legg-Calvé-Perthes disease.

文献出处：Peter Than, Vilmos Halmai, Shoaib Shaikh, János Kránicz, Arpád Bellyei. Long-term results of derotational femoral varus osteotomy in Legg-Calvé-Perthes disease: 26-year follow-up. Orthopedics. 2003 May;26(5):487-91. doi: 10.3928/0147-7447-20030501-13.