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患儿:女,2岁4个月,因被机动三轮车撞伤,在当地医院行脾切除,自体脾脏移植,左肾修补手术。术后切口愈合良好,血尿消失,但右髋关节不活动,局部压痛。伤后2周时X线片发现右髋关节脱位,右股骨头骨骺滑脱,转来本院。查体:一般情况好,右髋关节屈曲、外展、外旋位,右下肢短缩畸形,右髋前侧肿胀,腹股沟韧带中点处压痛,髋活动受限,右大粗隆突起上移。X线片示,右股骨头向后上方脱位,股骨头骨骺完全分离(附图)。入院后行患肢皮牵引,10d后在基础加硬膜外麻醉下行右髋关节切开复位,滑脱骨骺整复,3枚克针固定,单侧髋人字石膏外固定。术后切口Ⅰ期愈合,X线片复查示髋关节,股骨头骨骺滑脱复位良好,痊愈出院。术后8月X线片示滑脱骨骺愈合好。
Children: Female, 2 years old 4 months, was hit by a motor tricycle, splenectomy in the local hospital, autologous spleen transplantation, left kidney repair surgery. Postoperative wound healing, hematuria disappeared, but the right hip inactivity, local tenderness. 2 weeks after injury X-ray findings of right hip dislocation, right femoral epiphysis slipping, transferred to the hospital. Physical examination: the general condition is good, the right hip flexion, abduction, external rotation, shortening of the right lower limb deformity, swelling of the right hip anterior midline, inguinal ligament midpoint tenderness, limited hip mobility, . X-ray showed that the right femoral head posterior dislocation, complete separation of the femoral head epiphyseal (with photos). After admission, the affected skin was pulled. After 10 days, the right hip joint was opened and resected on the basis of extra-epidural anesthesia. The epiphysis was slipping off, followed by 3 g of needle fixation and unilateral hip prosthesis fixation. Postoperative incision healed, X-ray examination showed that the hip, femoral epiphysis suture reset well, healed and discharged. Postoperative radiographs of the X-ray showed epiphyseal healed well.