TRAPDOOR PROCEDURE FOR OSTEONECROSIS WITH SEGMENTAL COLLAPSE OF THE FEMORAL-HEAD IN TEENAGERS

被引：41

作者：

KO, JY ^{[1
]}

MEYERS, MH ^{[1
]}

WENGER, DR ^{[1
]}

机构：

[1] UNIV CALIF SAN DIEGO,CHILDRENS HOSP,DEPT ORTHOPED,SAN DIEGO,CA

来源：

JOURNAL OF PEDIATRIC ORTHOPAEDICS | 1995年 / 15卷 / 01期

关键词：

ADOLESCENT; FEMORAL HEAD OSTEONECROSIS; TRAPDOOR PROCEDURE;

D O I：

10.1097/01241398-199501000-00003

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Osteonecrosis of the femoral head in adolescents often leads to serious destructive changes in the hip with resulting significant disability. Between March 1981 and June 1990 we treated 13 teenagers (14 hips) using the ''trapdoor'' bone grafting procedure for severe femoral head osteonecrosis with articular surface collapse. Nine cases (10 hips) had the trapdoor procedure combined with containment osteotomy of the femur and acetabulum. Thirteen of the 14 hips had adequate follow-up to be included in this report. The main focus of this report is the 10 hips treated with a trapdoor bone grafting plus containment procedure (femoral osteotomy, acetabular osteotomy, or both). At an average follow-up of 4 years 5 months, clinically seven cases (eight hips) had a good result and two had a fair result. Radiographic evaluation showed six hips with a good result, three hips with a fair result, and one with a poor result. None of these 10 hips has yet required hip fusion or replacement arthroplasty, suggesting that trapdoor bone grafting plus containment can serve as a procedure to delay the need for hip fusion in femoral head avascular necrosis in teenagers.

引用

页码：7 / 15

页数：9

共 33 条

[1]

Amstutz H.C., The hip in Gaucher’s disease, Clin Orthop, 90, pp. 83-89, (1973)

[2]

Arlet J., Ficat P., Forage-biopsie de la tete femorale dans l’osteonecrose primitive. Observations histo-pathologiques portant sur huit forages, Rev Rhum Mai Osteoartic, 31, pp. 257-264, (1964)

[3]

Canale S.T., Bourland W.L., Fracture of the neck and intertrochanteric region of the femur in children, J Bone Joint Surg [Am], 59, pp. 431-443, (1977)

[4]

Catteral A., The natural history of Perthes disease, J Bone Joint Surg [Br], 53, pp. 37-53, (1971)

[5]

Chandler H.P., Reineck F.T., Wixson R.L., McCarthy J.C., Total hip replacement in patients younger than thirty years old, J Bone Joint Surg [Am], 63, pp. 1426-1434, (1981)

[6]

Chung S., Alavi A., Russell M.O., Management of osteonecrosis in sickle-cell anemia and its genetic variants, Clin Orthop, 130, pp. 158-174, (1978)

[7]

Cordeiro E.N., Femoral osteotomy in Legg-Calve-Perthes disease, Clin Orthop, 150, pp. 69-72, (1980)

[8]

Crutcher J.P., Staheli L.T., Combined osteotomy as a salvage procedure for severe Legg-Calve-Perthes disease, J Pediatr Orthop, 12, pp. 151-156, (1992)

[9]

D'Aubigne R.M., Postel M., Mazabrand A., Massias P., Gueguen J., Idiopathic necrosis of the femoral head in adults, J Bone Joint Surg [Br], 47, pp. 612-633, (1965)

[10]

Ficat R.P., Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment, J Bone Joint Surg [Br], 67, pp. 3-9, (1985)

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