【word】 骨牵引在青少年股骨头骨骺滑脱治疗中的应用价值

【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 2002??9?l?? 2007??8?l???8???????a???????M???????u12???)???Z?O8??j0??4??j0????????1l??14???)???”???? 13?I1???c?C???????u7??j0?x?C????5??j0?????C???????u???-????l??????????????????(3??)j0?Zj2?? ???C???????u(4??)???x?C???????u(4??)?’???????????B????????????? <2???)?I?-?????(?????? 1sp2??????????????j0???-x???D?”?$?????????????????M?????)?????? ???????M?????x??????j0???- Iowa?????????1???????I????????????????j0????12???”???????)????????1?I5??5???)???”2?I6??j0?C ?????u?????<???????<?I???L?I???????M?????I?????M?????”???>?????0?c?x?C???????u???????M?? ?????<???I???<?I???L?I?”?3?>?????0(Jp<0?I05o??l???????????x?_???x?C???????u???f?????M?} ?@?E?????B?)?????K???N????????j0????Iowa?????????186?1?)?????”?-90?1???5j0???????????? ?????????<?????x?C???????u?x???’???????)?R???????c?????Zj2??? ??C???????u?)?????<???’j0 jw???H??ja???a???c?????<?x?????c?????M?c?????c???? 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???????????????? ?u???????????)?<?????????M???????????????T ?????a?I?(??????j0?????????-?????????I?>?? ???a???)?????$?a?????????????}2?o100000(?I?? ?,????)1121j0???@?a???|???N???M?????x???????)?? doi?r10?I3969?oj?Iissn?I1671-6353?I2010?I04?I009 ???8?????rI|I???k???E???D???????k??A,JL????(?????2???C ?0?)l10004)?)E-mail?rwebsyy@tom?Icorn ??267?? ???????? ?????3????????j0?????Z?????H???????????????? ???????a?)?A?????x?C???????u??????j0?,???? 2002??9?l?????-?????<??(?B)???????????????? ???M???????u12???)?????????(j0 ?????I???? ??j2?M???D?? ?,??2002??9?l??2007??8?l???????a???? ,bJL?)t-???_??2010??8?l?,9???,4?fJournal0fClinicalPediatricSurgery?) 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?u?L?I???x?-?B?)???)????????j0????2???I???1 ?f???)4???I???????f??j0?x?C?????u?L?I???- Petrie?????????????)?x?????-???????????)?????f ???????j10??12?????5j0?????f?????????????? ?????(?)???f?M?????????????????????)???????? ????j0???f?????3?????????????)?A???Zj2???????u ?8?3?w?w?(????????j0???????????????????l?I?? ?????????)?Y?????????????x??????4??5???)?G?t ?????$?L????????j0 ?k?$?)???a???????M???????u?????????,???? ???????)????????j0???????????<?????x?C?????u ?x???’??????j2?K???N?????????)?0?l?a???????k ??????j0?????Zj2?????C?????u?)?????<???’?)?????? ????????????j0 ???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