股骨头前部骨吸收模式对legg - calv - perthes病的预后价值。

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Childrens Orthopaedics Pub Date : 2023-06-01 DOI:10.1177/18632521231164985
Kenichi Mishima, Yasunari Kamiya, Masaki Matsushita, Shiro Imagama
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引用次数: 0

摘要

目的:探讨股骨头前部骨吸收模式的差异是否与legg - calv - perthes病的预后相关。方法:1987 ~ 2013年,78例6.0岁后确诊的单侧legg - calv - perthes病患者行Salter无名截骨术,随访至骨骼成熟。通过骨折期间拍摄的蛙腿侧位髋关节x线片评估股骨头前路骨吸收模式,并将其分为两种类型,骨骺保存型(P)和骨骺破坏型(D)。分析骨吸收类型与Stulberg结果之间的相关性。结果:Stulberg结果为I级9例,II级31例,III级35例,IV级3例,平均随访时间8.3±2.7年。51例为P型髋关节,27例为D型髋关节。在对年轻组(诊断时6.0-8.9岁)改良侧柱b组髋关节患者的亚组分析中,两种类型的有利和不利结果的百分比显着差异(p = 0.013)。D型髋的股骨头前后侧增大明显大于P型髋(P = 0.014)。结论:通过关注股骨头前部的骨吸收模式,可以预测侧柱b组髋关节患者骨骼成熟时的不良髋关节形态。证据等级:III级,预后研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Prognostic value of bone resorption pattern in the anterior portion of the femoral head in Legg-Calvé-Perthes disease.

Purpose: To examine whether differences in bone resorption patterns in the anterior portion of the femoral head correlate with the prognosis of Legg-Calvé-Perthes disease.

Methods: Seventy-eight patients with unilateral Legg-Calvé-Perthes disease, who were diagnosed after 6.0 years of age, underwent the Salter innominate osteotomy from 1987 to 2013, and were followed up to skeletal maturity. The anterior bone resorption pattern of the femoral head was evaluated from a frog-leg lateral hip radiograph made in the middle of the fragmentation period, and classified into two types, an epiphysis-preserved type (P) and a physis-disrupted type (D). The correlation between the type of bone resorption and the Stulberg outcome was analyzed.

Results: The Stulberg outcomes were grade I for 9 patients, grade II for 31, grade III for 35, and grade IV for 3, with a mean follow-up period of 8.3 ± 2.7 years. Fifty-one patients demonstrated the type P hips and 27 did the type D hip. In a subset analysis of patients with the modified lateral pillar group-B hips in the younger group (6.0-8.9 years of age at diagnosis), the percentages of the favorable and unfavorable outcomes significantly differed between the two types (p = 0.013). Anteroposterior enlargement of the affected femoral head was significantly greater in the type D hips than the type P hips (p = 0.014).

Conclusion: Unfavorable hip morphology at skeletal maturity can be predicted in patients with the lateral pillar group-B hips by focusing on bone resorption patterns of the anterior portion of the femoral head.

Level of evidence: Level III, prognostic study.

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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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