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首页> 外文期刊>Revista Brasileira de Ortopedia >CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD
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CORRELATION BETWEEN AVASCULAR NECROSIS AND EARLY STABILIZATION OF PROXIMAL FEMORAL FRACTURES IN CHILDHOOD

机译:幼儿股骨近端骨折与血管坏死的关系

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ABSTRACT Objective: We developed this study with the aim of evaluating the results from treating patients with proximal femoral fractures, in a series of cases. We sought to observe the influence of the most prevalent complications on the final results after a minimum follow-up of two years. We especially considered the relationship between establishment of avascular necrosis and the time between the accident and the therapeutic intervention. Method: We retrospectively studied proximal extremity fractures of the femur in 29 patients under 14 years of age between 1988 and 2007. We analyzed the following variables: sex, age, mechanism of injury, fracture classification (Delbet), treatment administered, complications (pseudarthrosis, varus deformity, leg length discrepancy and avascular necrosis), duration of surgery and results (Ratliff). We carried out individual descriptive analysis on each variable. The tests were used in accordance with the premise that normality applied. For the evaluation, we used Fisher's exact test. Results: Five patients (17.2%) had avascular necrosis, and three of them (60.0%) were over 10 years of age. 73.3% of the patients treated within the first 24 hours showed good results. The most common cause of fractures was traffic accidents (44.8%). The best results were observed among patients who were treated surgically. 41.4% developed some type of complication. Conclusions: Among the 29 patients treated, 58.6% had good, 27.6% had regular and 13.8% had poor results, according to the Ratliff criteria. When conservative treatment was applied, only 17.0% had good results, while 69.3% had good results from surgical intervention. Likewise, 73.3% of the results were good results when surgery was performed within the first 24 hours and only 42.8% of the results were good among patients who underwent surgery after this period. Patients operated within the first 24 hours developed necrosis of the femoral head in 13.3% of cases, while 21.4% of those operated after this period developed this complication.
机译:摘要目的:我们开展这项研究的目的是评估在一系列病例中治疗股骨近端骨折患者的结果。我们试图观察最少两年的随访后最普遍并发症对最终结果的影响。我们特别考虑了血管坏死的形成与事故与治疗干预之间的时间之间的关系。方法:我们回顾性研究了1988年至2007年之间29岁以下14岁以下患者的股骨近端骨折。我们分析了以下变量:性别,年龄,损伤机制,骨折分类(Delbet),所用治疗,并发症(假关节) ,内翻畸形,腿长差异和无血管坏死),手术时间和结果(Ratliff)。我们对每个变量进行了单独的描述性分析。根据应用正常性的前提使用测试。为了进行评估,我们使用了Fisher的精确检验。结果:5例(17.2%)患有血管坏死,其中3例(60.0%)年龄超过10岁。在最初的24小时内接受治疗的患者中有73.3%表现出良好的效果。骨折的最常见原因是交通事故(44.8%)。在接受手术治疗的患者中观察到最好的结果。 41.4%的人出现某种类型的并发症。结论:根据Ratliff标准,在接受治疗的29例患者中,有58.6%的患者良好,有常规的27.6%的患者,有13.8%的患者的结果较差。当采用保守治疗时,只有17.0%的患者取得了良好的效果,而69.3%的患者通过手术干预获得了良好的效果。同样,在最初的24小时内进行手术时,有73.3%的结果是良好的结果,而在此期间接受手术的患者中,只有42.8%的结果是良好的。在头24小时内手术的患者发生股骨头坏死的病例为13.3%,而在此期间术后的患者中有21.4%发生了这种并发症。

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