儿童股骨颈骨折治疗方法的研究进展
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摘要
儿童股骨颈骨折的发生率极低,是一种罕见的损伤。但随着社会的发展,交通事故、自然灾害、高坠伤等意外事故的增多,儿童股骨颈骨折的发生率也较前有所升高。儿童股骨颈骨折很难治疗,因儿童股骨颈自身的特点,比如血供差、有促进股骨生长的骺板等,很容易发生并发症,且并发症致残率非常高,处理困难、远期疗效较差,因此应采取措施尽量减少并发症的发生。
Femoral neck fracture is a rare injury in children,however,the incidence is increasing with traffic accidents,natural disasters and fortuities. Because of the characteristics of children's femoral neck,such as poor blood supply and epiphyseal plate which can promote femur growth,femoral neck fracture in children is difficult to be treated; the complication rate and disability rate are high and the long-term prognosis is poor.Effective measures should be taken to minimize complications.
Femoral neck fracture is a rare injury in children,however,the incidence is increasing with traffic accidents,natural disasters and fortuities. Because of the characteristics of children's femoral neck,such as poor blood supply and epiphyseal plate which can promote femur growth,femoral neck fracture in children is difficult to be treated; the complication rate and disability rate are high and the long-term prognosis is poor.Effective measures should be taken to minimize complications.
引文
[1]孟祥栋,张宗武.手术与非手术治疗儿童股骨颈骨折的疗效比较[J].中国骨与关节损伤杂志,2018,33(5):538-539. DOI:10. 7531/j. issn. 1672-9935. 2018. 05. 033.Meng XD,Zhang ZW. Comparison of surgical and non-surgical treatment of femoral neck fracture in children[J]. Chinese Journal of Bone and Joint Injury,2018,33(5):538-539. DOI:10. 7531/j. issn. 1672-9935. 2018. 05. 033.
[2]王鹏,栗树伟,王东,等.青少年股骨颈骨折后股骨头坏死的研究进展[J].中国社区医师,2017,33(12):8-9,12. DOI:10.3969/j. issn. 1007-614x. 2017. 12. 3.Wang P,Li SW,Wang D,et al. Research progress of femoral head necrosis after femoral neck fracture in adolescents[J].Chinese Community Doctors,2017,33(12):8-9,12. DOI:10.3969/j. issn. 1007-614x. 2017. 12. 3.
[3]Chung SM. The arterial supply of the developing proximal end of the human femur[J]. J Bone Joint Surg Am,1976,58(7):961-970.
[4]Johnson EO,Soultanis K,Soucacos PN. Vascular anatomy and microcirculation of skeletal zones vulnerable to osteonecrosis:vascularization of the femoral head[J]. Orthop Clin North Am,2004,35(3):285-291,Ⅷ. DOI:10. 1016/j. ocl. 2004. 03. 002.
[5]Ganz R,Gill TJ,Gautier E,et al. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis[J]. J Bone Joint Surg Br,2001,83(8):1119-1124.
[6]Bukva B,Abramovic'D,Vrgo? G,et al. Femoral neck fractures in children and the role of early hip decompression in final outcome[J].Injury,2015,46(Suppl 6):S44-47. DOI:10. 1016/j. injury.2015. 10. 059.
[7]张保焜,张伟.股骨颈骨折分型与治疗[J].国际骨科学杂志,2017,38(3):149-153. DOI:10. 3969/j. issn. 1673-7083. 2017.03. 002.Zhang BK,Zhang W. Classification and treatment of femoral neck fracture[J]. International Journal of Orthopaedics,2017,38(3):149-153. DOI:10. 3969/j. issn. 1673-7083. 2017. 03. 002.
[8]Black KJ,Bevan CA,Murphy NG,et al. Nerve blocks for initial pain management of femoral fractures in children[J]. Cochrane Database Syst Rev,2013(12):CD009587. DOI:10. 1002/14651858. CD009587.
[9]Caldwell L,Chan CM,Sanders JO,et al. Detection of femoral neck fractures in pediatric patients with femoral shaft fractures[J].J Pediatr Orthop,2017,37(3):e164-e167. DOI:10. 1097/BPO.0000000000000800.
[10]Haddad FS,Bann S,Hill RA,et al. Displaced stress fracture of the femoral neck in an active amenorrhoeic adolescent[J]. Br J Sports Med,1997,31(1):70-72.
[11]Boyle MJ,Hogue GD,Heyworth BE,et al. Femoral neck stress fractures in children younger than 10 years of age[J]. J Pediatr Orthop,2017,37(2):e96-e99. DOI:10. 1097/BPO. 0000000000000739.
[12]Shrader MW,Schwab JH,Shaughnessy WJ,et al. Pathologic femoral neck fractures in children[J]. Am J Orthop(Belle Mead NJ),2009,38(2):83-86.
[13]田守进,朱贤,缪健荣,等.切开与闭合复位内固定治疗移位型儿童股骨颈骨折的Meta分析[J].中华创伤骨科杂志,2018,20(7):560-565. DOI:10. 3760/cma. j. issn. 1671-7600. 2018.07. 003.Tian SJ,Zhu X,Miao JR,et al. Displaced femoral neck fracture in children:closed versus open reduction:a meta-analysis[J].Chinese Journal of Orthopaedic Trauma,2018,20(7):560-565.DOI:10. 3760/cma. j. issn. 1671-7600. 2018. 07. 003.
[14]蔡春水,刘燕洁,林超文,等.空心螺钉与动力髋螺钉治疗股骨颈骨折的比较[J].中国矫形外科杂志,2017,25(22):2038-2041. DOI:10. 3977/j. issn. 1005-8478. 2017. 22. 05.Cai CS,Liu YJ,Lin CW,et al. Comparison of cannulated screw versus dynamic hip screw for the treatment of femoral neck fracture[J].Orthopedic Journal of China,2017,25(22):2038-2041. DOI:10. 3977/j. issn. 1005-8478. 2017. 22. 05.
[15]靳胜利,白玉明.隐匿性股骨颈骨折12例误漏诊原因分析并文献复习[J].临床误诊误治,2017,30(8):28-30. DOI:10.3969/j. issn. 1002-3429. 2017. 08. 009.Jin SL,Bai YM. Cause analysis for missed diagnosis and misdiagnosed 12 patients with occult femoral neck fractures and literature review[J]. Clinical Misdiagnosis&Mistherapy,2017,30(8):28-30. DOI:10. 3969/j. issn. 1002-3429. 2017. 08. 009.
[16]Yeranosian M,Horneff JG,Baldwin K,et al. Factors affecting the outcome of fractures of the femoral neck in children and adolescents:a systematic review[J]. Bone Joint J,2013,95-B(1):135-142. DOI:10. 1302/0301-620X. 95B1. 30161.
[17]周颖,王波,楼跃,等.三种内固定方式治疗儿童移位型股骨颈骨折的临床分析[J].中华创伤杂志,2017,33(11):1016-1021.DOI:10. 3760/cma. j. issn. 1001-8050. 2017. 11. 012.Zhou Y,Wang B,Lou Y,et al. Comparison of three internal fixation techniques for treating displaced femoral neck fractures in children[J]. Chinese Journal of Trauma,2017,33(11):1016-1021. DOI:10. 3760/cma. j. issn. 1001-8050. 2017. 11. 012.
[18]Ju L,Jiang B,Lou Y,et al. Delayed treatment of femoral neck fractures in 58 children:open reduction internal fixationversus closed reduction internal fixation[J]. J Pediatr Orthop B,2016,25(5):459-465. DOI:10. 1097/BPB. 0000000000000339.
[19]Morsy HA. Complications of fracture of the neck of the femur in children. A long-term follow-up study[J]. Injury,2001,32(1):45-51.
[20]Song KS. Displaced fracture of the femoral neck in children:open versus closed reduction[J]. J Bone Joint Surg Br,2010,92(8):1148-1151. DOI:10. 1302/0301-620X. 92B8. 24482.
[21]陈广辉,王洪伟,吴琼,等.儿童股骨颈骨折疗效及股骨头坏死相关因素分析[J].实用骨科杂志,2017,23(5):404-408.Chen GH,Wang HW,Wu Q,et al. The correlation factor analysis of therapeutic effect and femoral head avasculer necrosis for pediatric femoral neck fractures[J]. Journal of Practical Orthopaedics,2017,23(5):404-408.
[22]Ratliff AH. Fractures of the neck of the femur in children[J]. J Bone Joint Surg Br,1962,44-B:528-542.
[23]Hughes LO,Beaty JH. Fractures of the head and neck of the femur in children[J]. J Bone Joint Surg Am,1994,76(2):283-292.
[24]Maeda S,Kita A,Fujii G,et al. Avascular necrosis associated with fractures of the femoral neck in children:histological evaluation of core biopsies of the femoral head[J]. Injury,2003,34(4):283-286.
[25]Flynn JM,Wong KL,Yeh GL,et al. Displaced fractures of the hip in children. Management by early operation and immobilisation in a hip spica cast[J]. J Bone Joint Surg Br,2002,84(1):108-112.
[26]Elgeidi A,El-Negery A. Fibular strut graft for nonunited femoral neck fractures in children[J]. J Child Orthop,2017,11(1):28-35. DOI:10. 1302/1863-2548-11-16022.
[27]Ingram AJ,Bachynski B. Fractures of the hip in children; treatment and results[J]. J Bone Joint Surg Am,1953,35-A(4):867-887.
[2]王鹏,栗树伟,王东,等.青少年股骨颈骨折后股骨头坏死的研究进展[J].中国社区医师,2017,33(12):8-9,12. DOI:10.3969/j. issn. 1007-614x. 2017. 12. 3.Wang P,Li SW,Wang D,et al. Research progress of femoral head necrosis after femoral neck fracture in adolescents[J].Chinese Community Doctors,2017,33(12):8-9,12. DOI:10.3969/j. issn. 1007-614x. 2017. 12. 3.
[3]Chung SM. The arterial supply of the developing proximal end of the human femur[J]. J Bone Joint Surg Am,1976,58(7):961-970.
[4]Johnson EO,Soultanis K,Soucacos PN. Vascular anatomy and microcirculation of skeletal zones vulnerable to osteonecrosis:vascularization of the femoral head[J]. Orthop Clin North Am,2004,35(3):285-291,Ⅷ. DOI:10. 1016/j. ocl. 2004. 03. 002.
[5]Ganz R,Gill TJ,Gautier E,et al. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis[J]. J Bone Joint Surg Br,2001,83(8):1119-1124.
[6]Bukva B,Abramovic'D,Vrgo? G,et al. Femoral neck fractures in children and the role of early hip decompression in final outcome[J].Injury,2015,46(Suppl 6):S44-47. DOI:10. 1016/j. injury.2015. 10. 059.
[7]张保焜,张伟.股骨颈骨折分型与治疗[J].国际骨科学杂志,2017,38(3):149-153. DOI:10. 3969/j. issn. 1673-7083. 2017.03. 002.Zhang BK,Zhang W. Classification and treatment of femoral neck fracture[J]. International Journal of Orthopaedics,2017,38(3):149-153. DOI:10. 3969/j. issn. 1673-7083. 2017. 03. 002.
[8]Black KJ,Bevan CA,Murphy NG,et al. Nerve blocks for initial pain management of femoral fractures in children[J]. Cochrane Database Syst Rev,2013(12):CD009587. DOI:10. 1002/14651858. CD009587.
[9]Caldwell L,Chan CM,Sanders JO,et al. Detection of femoral neck fractures in pediatric patients with femoral shaft fractures[J].J Pediatr Orthop,2017,37(3):e164-e167. DOI:10. 1097/BPO.0000000000000800.
[10]Haddad FS,Bann S,Hill RA,et al. Displaced stress fracture of the femoral neck in an active amenorrhoeic adolescent[J]. Br J Sports Med,1997,31(1):70-72.
[11]Boyle MJ,Hogue GD,Heyworth BE,et al. Femoral neck stress fractures in children younger than 10 years of age[J]. J Pediatr Orthop,2017,37(2):e96-e99. DOI:10. 1097/BPO. 0000000000000739.
[12]Shrader MW,Schwab JH,Shaughnessy WJ,et al. Pathologic femoral neck fractures in children[J]. Am J Orthop(Belle Mead NJ),2009,38(2):83-86.
[13]田守进,朱贤,缪健荣,等.切开与闭合复位内固定治疗移位型儿童股骨颈骨折的Meta分析[J].中华创伤骨科杂志,2018,20(7):560-565. DOI:10. 3760/cma. j. issn. 1671-7600. 2018.07. 003.Tian SJ,Zhu X,Miao JR,et al. Displaced femoral neck fracture in children:closed versus open reduction:a meta-analysis[J].Chinese Journal of Orthopaedic Trauma,2018,20(7):560-565.DOI:10. 3760/cma. j. issn. 1671-7600. 2018. 07. 003.
[14]蔡春水,刘燕洁,林超文,等.空心螺钉与动力髋螺钉治疗股骨颈骨折的比较[J].中国矫形外科杂志,2017,25(22):2038-2041. DOI:10. 3977/j. issn. 1005-8478. 2017. 22. 05.Cai CS,Liu YJ,Lin CW,et al. Comparison of cannulated screw versus dynamic hip screw for the treatment of femoral neck fracture[J].Orthopedic Journal of China,2017,25(22):2038-2041. DOI:10. 3977/j. issn. 1005-8478. 2017. 22. 05.
[15]靳胜利,白玉明.隐匿性股骨颈骨折12例误漏诊原因分析并文献复习[J].临床误诊误治,2017,30(8):28-30. DOI:10.3969/j. issn. 1002-3429. 2017. 08. 009.Jin SL,Bai YM. Cause analysis for missed diagnosis and misdiagnosed 12 patients with occult femoral neck fractures and literature review[J]. Clinical Misdiagnosis&Mistherapy,2017,30(8):28-30. DOI:10. 3969/j. issn. 1002-3429. 2017. 08. 009.
[16]Yeranosian M,Horneff JG,Baldwin K,et al. Factors affecting the outcome of fractures of the femoral neck in children and adolescents:a systematic review[J]. Bone Joint J,2013,95-B(1):135-142. DOI:10. 1302/0301-620X. 95B1. 30161.
[17]周颖,王波,楼跃,等.三种内固定方式治疗儿童移位型股骨颈骨折的临床分析[J].中华创伤杂志,2017,33(11):1016-1021.DOI:10. 3760/cma. j. issn. 1001-8050. 2017. 11. 012.Zhou Y,Wang B,Lou Y,et al. Comparison of three internal fixation techniques for treating displaced femoral neck fractures in children[J]. Chinese Journal of Trauma,2017,33(11):1016-1021. DOI:10. 3760/cma. j. issn. 1001-8050. 2017. 11. 012.
[18]Ju L,Jiang B,Lou Y,et al. Delayed treatment of femoral neck fractures in 58 children:open reduction internal fixationversus closed reduction internal fixation[J]. J Pediatr Orthop B,2016,25(5):459-465. DOI:10. 1097/BPB. 0000000000000339.
[19]Morsy HA. Complications of fracture of the neck of the femur in children. A long-term follow-up study[J]. Injury,2001,32(1):45-51.
[20]Song KS. Displaced fracture of the femoral neck in children:open versus closed reduction[J]. J Bone Joint Surg Br,2010,92(8):1148-1151. DOI:10. 1302/0301-620X. 92B8. 24482.
[21]陈广辉,王洪伟,吴琼,等.儿童股骨颈骨折疗效及股骨头坏死相关因素分析[J].实用骨科杂志,2017,23(5):404-408.Chen GH,Wang HW,Wu Q,et al. The correlation factor analysis of therapeutic effect and femoral head avasculer necrosis for pediatric femoral neck fractures[J]. Journal of Practical Orthopaedics,2017,23(5):404-408.
[22]Ratliff AH. Fractures of the neck of the femur in children[J]. J Bone Joint Surg Br,1962,44-B:528-542.
[23]Hughes LO,Beaty JH. Fractures of the head and neck of the femur in children[J]. J Bone Joint Surg Am,1994,76(2):283-292.
[24]Maeda S,Kita A,Fujii G,et al. Avascular necrosis associated with fractures of the femoral neck in children:histological evaluation of core biopsies of the femoral head[J]. Injury,2003,34(4):283-286.
[25]Flynn JM,Wong KL,Yeh GL,et al. Displaced fractures of the hip in children. Management by early operation and immobilisation in a hip spica cast[J]. J Bone Joint Surg Br,2002,84(1):108-112.
[26]Elgeidi A,El-Negery A. Fibular strut graft for nonunited femoral neck fractures in children[J]. J Child Orthop,2017,11(1):28-35. DOI:10. 1302/1863-2548-11-16022.
[27]Ingram AJ,Bachynski B. Fractures of the hip in children; treatment and results[J]. J Bone Joint Surg Am,1953,35-A(4):867-887.