儿童髋关节骨折:病例系列

Alberto Daniel Navarro-Vergara , Alberto Navarro-Fretes
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摘要

目的了解手术延迟时间远高于现行指南的建议,展示所获得的结果,描述处理和经验。材料与方法回顾性研究连续0-16年髋部骨折病例,至少随访12个月。在分析流行病学变量时,根据Ratliff标准,延迟到达医院、延迟手术治疗、并发症和功能。结果髋部骨折21例。平均年龄9岁,左侧受累71%,双侧表现1例。42.8%的创伤机制与交通事故有关。伴有损伤的占33.3%。Delbet分类以IV型和III型为主。95%的病例手术治疗。到达医院的延误平均为1.6天,治疗延误5.45天。平均随访29个月(12-54个月)。66.6%的患者功能良好,23.8%为一般,9.5%为不良。7例出现并发症,其中NOA占19%,髋内翻8.5%,长度差异4%(4%)。结论这是一种罕见的骨折。作为儿科骨科医生,我们必须掌握各种类型损伤的最新处理方法,以便提供适当的治疗,减少可能存在的后遗症。目标应该是获得解剖复位和稳定的固定。手术延迟并不等同于不良结果。
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Fractura de cadera en la Infancia: serie de casos

Objectives

Show the results obtained, describing the management and experience, knowing that the surgical delay time is much higher than that recommended in the current guidelines.

Materials and method

Retrospective study of consecutive cases of hip fractures in the range of 0–16 years, with a minimum follow-up of 12 months. Where epidemiological variables were analyzed, delay in arrival at the Hospital, delay in surgical treatment, complications and functionality according to the Ratliff criteria.

Results

Twenty-one cases of hip fractures. An average age of 9 years, 71% left-sided involvement, one case of bilateral presentation. The trauma mechanism was 42.8% related to a traffic accident. There were associated injuries in 33.3%. Predominance of type IV and type III according to the Delbet classification. Surgical treatment in 95% of cases. The delay in arrival at the hospital was 1.6 days on average, with a delay in treatment of 5.45 days. Average follow-up of 29 months (12–54 months). Excellent functional results were obtained in 66.6% of cases, fair in 23.8%, and poor results in 9.5. Complications occurred in 7 cases, with NOA in 19% of patients, coxa vara in 8.5%, and length discrepancy in 4% (4%).

Conclusions

They are rare fractures. As pediatric orthopedists, we must be up-to-date in the management of each type of injury, in order to offer the appropriate treatment that reduces the sequelae that may potentially exist. The goal should be to obtain anatomical reductions and stable fixations. And surgical delay is not synonymous with poor results.

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