背景:评估Legg-Calve-Perthes病的关节舒张疗效。
方法:使用外部固定器(Orthofix)对7名至少8岁的诊断为Legg-Calve-Perthes病的患者进行了关节扩张。平均随访80个月(范围,32至149个月),他们的平均年龄为9.1岁(范围,8至12年)。通过测量术后6个月的髋部疼痛程度和髋部活动范围并将其与术前测量值进行比较来评估治疗结果。通过骨epi指数评估放射学恢复,并与术前值进行比较。在最后的后续行动中,使用Iowa髋关节评分和Stulberg分类评估临床和放射学结果.
结果:在关节扩张后6个月进行的临床评估中,疼痛程度平均下降1.8分,和平均屈曲,内部旋转,外展增加了35°,16°,11°,分别。根据放射学发现,骨phy指数平均显着增加6.6(从术前的19增加到术后的26)。在最后的后续行动中,爱荷华州髋部平均评分从术前的65分提高至84分.有1个Stulberg班我的臀部,2StulbergII类臀部,3StulbergIII级臀部,1Stulberg四级臀部,也没有StulbergV级髋关节.
结论:我们得出的结论是,使用外固定器进行关节扩张可以是治疗迟发性Legg-Calve-Perthes病的一种相对有希望的手术方法。
BACKGROUND: To evaluate the efficacy of
arthrodiastasis for Legg-Calve-Perthes disease.
METHODS: Arthrodiastasis was conducted using external fixator devices (Orthofix) in 7 patients at least 8 years of age with a diagnosis of Legg-Calve-Perthes disease. The average follow-up was 80 months (range, 32 to 149 months), and their average age was 9.1 years (range, 8 to 12 years). The results of treatment were evaluated by measuring the degree of hip pain and the range of motion of the hip at 6 months after the operation and comparing the values with preoperative measurements. Radiological recovery was evaluated by the epiphyseal index and compared with the preoperative values. At the final follow-up, clinical and radiological results were evaluated using the Iowa hip score and the Stulberg classification.
RESULTS: On the clinical evaluation performed at 6 months after
arthrodiastasis, the degree of pain decreased by 1.8 points on average, and the average flexion, internal rotation, and abduction increased by 35°, 16°, and 11°, respectively. Based on radiological findings, the epiphyseal index showed a remarkable increase of 6.6 on average (from 19 preoperatively to 26 postoperatively). At the final follow-up, the average Iowa hip score improved from 65 points preoperatively to 84 points. There were 1 Stulberg class I hip, 2 Stulberg class II hips, 3 Stulberg class III hips, 1 Stulberg class IV hip, and no Stulberg class V hip.
CONCLUSIONS: We conclude that
arthrodiastasis using an external fixator can be a relatively promising surgical procedure for the treatment of late-onset Legg-Calve-Perthes disease.