粗隆间Imhäuser截骨联合软骨成形术治疗中重度稳定型股骨骨骺滑动:病例系列研究

T. Abdelaziz, S. Elbeshry, A. Goda, Tamer A. Fayyad, A. Aly, Shady Mahmoud
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引用次数: 5

摘要

本研究的目的是评估Imhäuser截骨联合软骨成形术短期治疗中重度稳定型股骨头骨骺滑动(SCFE)的安全性和有效性。19例(20髋)中重度稳定型SCFE患者行Imhäuser截骨联合软骨成形术治疗,随访3-4年。患者手术时年龄在12至18岁之间,主诉有各种症状和体征,包括疼痛、跛行、活动范围有限和/或外展肌无力。使用临床和放射学参数以及功能结果测量来评估结果:“哈里斯髋关节评分”(HHS)和“安大略省西部和麦克马斯特大学骨关节炎指数”(WOMAC)。屈曲、内旋和外展ROM均有统计学意义上的改善。HHS和WOMAC均有显著改善,最终随访评分分别为86.76分和6.4%。随访结束时,影像学指标Southwick角(平均12.8°)、alpha角Nötzli(平均29.85°)、Hilgenreiner骨骺角(平均37.65°)、颈轴角(平均140.63°)、髋臼-粗隆距离(平均14.1 mm)均有显著改善。Imhäuser截骨联合骨软骨成形术是中重度稳定SCFE治疗的良好选择。
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Intertrochanteric Imhäuser osteotomy combined with osteochondroplasty in treatment of moderate-severe stable slipped capital femoral epiphysis: a case series study
The aim of the study is to assess the safety and efficacy of Imhäuser osteotomy combined with osteochondroplasty in the treatment of moderate-severe stable slipped capital femoral epiphysis (SCFE) on short-term basis. Nineteen patients (20 hips) with moderate-severe stable SCFE were surgically treated by Imhäuser osteotomy combined with osteochondroplasty and followed up for 3–4 years. The cases aged between 12 and 18 years at the time of surgery and complained of a variety of symptoms and signs that included pain, limping, limited range of motion (ROM), and/or abductor weakness. The outcomes were assessed using clinical and radiological parameters as well as functional outcome measures: “Harris hip score” (HHS) and “The Western Ontario and McMaster Universities Osteoarthritis Index” (WOMAC). There were statistically significant improvements in flexion, internal rotation, and abduction ROM. HHS and WOMAC improved significantly with final follow-up scores at 86.76 and 6.4%, respectively. The radiological parameters showed significant improvement regarding Southwick angle (mean 12.8°), alpha angle of Nötzli (mean 29.85°), Hilgenreiner epiphyseal angle (mean 37.65°), neck shaft angle (mean 140.63°), and acetabulo-trochanteric distance (median14.1 mm) at the end of follow-up period. Imhäuser osteotomy combined with osteochondroplasty is a good option in moderate-severe stable SCFE treatment.
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