摘要
目的回顾性分析Perthes病治疗的经验，结合系统文献复习，以确定治疗的指征和方法。方法17例（平均6．4岁）Perthes病中，CatterallⅠ型3例，Ⅱ型4例，Ⅲ型7例，Ⅳ型3例。分别采取支具或石膏固定（4例），滑膜切除髓腔减压或植骨（3例），Salter或Chairi截骨治疗（10例）。采用临床和X线片动态随访，按Stulberg标准进行疗效评价。结果术后平均随访24（6～52）个月。4例采用石膏或支具外固定的CatterallⅠ和Ⅱ型病例均取得全优效果；采用滑膜切除髓腔减压或植骨的CatterallⅠ和Ⅱ型病例，2优，1中；采用Salter或Chairi截骨治疗CatterallⅢ和Ⅳ型的10个病例，5优，3良，2中。结论严格应用Perthes病临床分型，选择合适的治疗方法是提高此疾患治愈效果的重要手段。
Objective To figure out an effective combined treatment system for Perthes disease. Methods A total of 17 pediatric patients （with a mean age of 6.4 years） with Perthes disease with classification of Catterall Ⅰ （3 cases） , Ⅱ （4 cases） , Ⅲ （7 cases）, Ⅳ （3 cases） were treated with cast （4 cases） , core decompression （3 cases） , Salter and Chairi osteotomy （10 cases） , respectively. The outcomes were analyzed with Stulberg criteria. Results Average follow-up time was 24 months （ 6 - 52 months）. All the four patients of Catterall Ⅰ and Ⅱ classification who were treated with cast had the best outcome, and the other three patients treated with core decompression had excellent outcome （ in two patients） and good outcome （ in one patient）. All the ten patients classified as Catterall Ⅲ and Ⅳ were treated with Salter or Chairi osteotomy, got excellent outcome （in five patients）, good outcome （ in three patients） and fair outcome （ in two patients）. Conclusion Following the Catterall classification and combined treatment for Perthes disease is crucial for improvement in prognosis.
出处
《临床军医杂志》
CAS
2008年第6期900-902,共3页
Clinical Journal of Medical Officers
关键词
PERTHES病
治疗
儿童
Legg-Calve-Perthes disease
treatment
children
