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目的:探讨带血管蒂大转子骨膜瓣转位治疗儿童股骨颈骨折的疗效。方法:25例儿童股骨颈骨折患者,骨折按Delbet分型:Ⅰ型2例,Ⅱ型13例,Ⅲ型9例,Ⅳ型1例。全部病例均行切开复位,克氏针或空心加压螺钉固定,并用旋股内侧动脉深支蒂大转子骨膜瓣转位治疗。结果:所有病例经1-5年随访(其中20例随访3年以上),骨折均愈合。2例Ⅱ型及1例Ⅲ型发生股骨头坏死,1例发生骨骺早闭。按Harris髋关节功能评分系统评定:优15例,良好7例,差3例,优良率达88.0%。结论:带血管蒂大转子骨膜瓣可促进骨折愈合,减少股骨头缺血性坏死的发生率,是治疗儿童股骨颈骨折的有效方法。
Objective: To investigate the curative effect of transposition of pedicled great trochanter periosteum flap on femoral neck fracture in children. Methods: Twenty - five children with femoral neck fracture were divided into two groups according to Delbet classification: type Ⅰ in 2 cases, type Ⅱ in 13 cases, type Ⅲ in 9 cases and type Ⅳ in 1 case. All patients underwent open reduction, Kirschner wire or hollow compression screw fixation, and the medial femoral artery deep pedicle pedicle periosteal flap transposition treatment. Results: All cases were followed up for 1-5 years (20 cases were followed up for more than 3 years), and the fractures healed. 2 cases of type Ⅱ and 1 case of type Ⅲ osteonecrosis of the femoral head, epiphysis occurred in 1 case of early closure. By Harris hip function scoring system assessment: excellent in 15 cases, good in 7 cases, poor in 3 cases, excellent and good rate of 88.0%. CONCLUSION: The pedicled great trochanter periosteal flap can promote fracture healing and reduce the incidence of avascular necrosis of the femoral head. It is an effective method for the treatment of femoral neck fracture in children.