【word】 骨牵引在青少年股骨头骨骺滑脱治疗中的应用价值
骨牵引在青少年股骨头骨骺滑脱治疗中的
应用价值
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Bonetractioninthetreatmentofslippedcapttaifemoralepiphysisinadolescent?IWANGEn-bo?)WANG
Kang,ZHANGLi-jun?)eta1?IShengjingHospitalofChinaMedicalUniversity?)Shenyang,110004?)China
jwAbstractjaObjectiveToevaluatethefunctionofbonetractioninthetreatmentofslippedcapitalfemoral
epiphysis(SCFE)inadolescent?IMethods12casesofSCFEwere
retrospectivelyreviewedfromSeptember2002
to
August2007wit}laverageage13?I1years(rangedfrom11to14yearsold)?ITherewere8easesinmalej04in
female?)7stablecasesand5unstableones?IMildslippages(3cases)werefixedinsirewithsinglecannulatedscrew?I
Moderatetoseverestableslippages(4cases)andunstableslippages(4cases)weretreatedwithdistalfemoralbone
tractioninabductionandintemalrotationforabout2weeksfollowedwit}lfLxationbylor2eannulatedscrews
pereutaneouslyundergeneralanesthesia?IThefemoralreductionswereestimatedbyhead-shaftanglepreo-
perativelyandpostspoperatively?ITheIowaHipScoresystemwasusedeval
uatethefunctionalresultsatlast
followup?IResultsAllcageswerefollowedupwiththeaverageperiodof2?I6years(1?I5??5years)?ITherewereno
differenceinhead-shaftanglebetweenpretraction?)posttraetionandpostoperationinstablecases(P>0?I05)?I
Therewerestatisticdifferencebetweenpretraetionandposttraction?)postoperationrespectivelyinunstablecages
(P<0?I05)?IExceptforone
patientwithcomplextreatmentturnedouttobeavascularnecrosisoffemoralheadwith
IowaHipScore86scores?)therewerenomaincomplicationsintheothercaseswithIowaHipScoreabove90
points?IConclusionsGoodreductioncouldbeexpectedinunstableSCFEbybonetractionbeforefLxation??thless
complication?IBonetractionwouldbeinvalidinstableSCFE?I
jwKeywordsjaAdolescent?cSkehtalTractingreposition?cFemurHead?cEpiphyses?cTherapy
?????M???????u(SlippedCapitalFemoral
Epiphysis?)serE)?L?4?-???a???f????????????????
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doi?r10?I3969?oj?Iissn?I1671-6353?I2010?I04?I009
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???9???H
1NoguchiY?)SakamakiT?IEpidemiologyanddemographicsof
slippedcapitalfemoralepiphysisinJapan?ramuhicenterstudy
bytheJapanesePaediatricOrthopaedicAssociationjwJjaJ
OrthopSei?)2002?)7(6)?r610-617?I
2???????)???V?f?)???????)?]???????????????????????M??
?????u??I?M??????jwJ1?I?M??d,JL?<t”???_???)2004?)3(4)?r
24l??244?I
3SouthwickWO?IOsteotomythroughthelessertrochanterfor
slippedcapitalfemoralepiphysisjwJja-JBoneJointSurgAm?)
1967?)49(5)?r807-835?I
4ParsehKZehenderH?)BnhiT’eta1?IIntertrochantericcorrective
osteotomyformoderateandseverechronicslippedcapital
femoralepiphysis[J]?IJPediatrOrthopB?)1999?)8(3)?r223-230?I
5KayRM?ISlippedCapitalFemoralEpiphysisIn?rMorrissyRT,
ed?ILovellandWinterj0spediatricorthopacdies?I6thed?I
Philadelphia?rLippincott,2003?)1086-1124?I
6NisarA?)SalamaA?)FreemanJV?)etai?IAvascularnecrosisin
acuteandacute-on-chronicslippedcapitalfemoralepiphysis
jwJja?IJPediatrOahopB?)2007?)16(6)?r393-398?I
7YildirimY?)BautistaS?)DavidsonRS?IChondrolysis?)osteonecro-
sis?Iandslipseverityinpatientswithsubsequenteontralateral
slippedcapitalfemoralepiphysisjwJja?IJBoneJointSurgAm?)
2008?)90(3)?r485--492?I
8MamischTC?)KimYJ?)RieholtJA?)eta1?IFemoralmorphologydue
toimpingementinfluencestherangeofmotioninslipped
capitalfemoralepiphysis[J]?IClinOrthopRelatRes?)2009,467
(3)?r692-698?I
9???????)???J???I?????M???????u8?????????r?M?I?Z???o
?|?B???_???)1996?)27(2)?r85sp87?I
10DietzFR?ITractionreductionofacuteandacute-onspchronic
slippedcapitalfemoralepiphysisjwJja?IClinOrthopRelatRes?)
1994?)302?r101-110?I
11C??winRC?)MaharAT?)Oswald”IS?)eta1?IScrewheadimpinge-
mentafterinsitufixationinmoderateandsevereslippedcapsp
italfemoralepiphysisjwJja?IJPediatrOrthop?)2007?)27(3)?r
319sp325?I
12KishanSj0UpasaniVj0MaharA?)eta1?IBiomechaniealstabilityof
singlespscrewver$ustwo-screwfixationofanunstableslipped
capitalfemoralepiphysismodel?reffectofscrewpositioninthe
femoralneeklJ]?IJPediatrOrthop?)2006?)26(5)?r601-605?I
13KalogrianitisS,TanCK?)KempGJ?)eta1?IDoesunstableslipped
capitalfemoralepiphysisrequireurgentstabilization?[J1?IJ
PediatrOrthopB?)2007?)16(1)?r6-9?I
14DiabM?IHreskoMT,MillisMB?IIntertrochantericyer$us
subcapitalosteotomyinslippedcapitalfemoralepiphysis[J]?I
ClinOrthopRelatRes?)2004?)(427)?r204sp12?I