Application direct anterior approach in pediatric femoral head and neck lesions

作者全名："Zheng, Jian; Zhang, Yanting; Nan, Guoxin"

作者地址："[Zheng, Jian; Nan, Guoxin] Guangdong Med Univ, Dongguan Childrens Hosp, Dongguan Peoples Hosp 8, Dongguan Inst Pediat, Dongguan 523326, Peoples R China; [Zheng, Jian; Zhang, Yanting] Chongqing Med Univ, Chongqing 400016, Peoples R China; [Nan, Guoxin] Dongguan Eighth Peoples Hosp, Dongguan, Peoples R China; [Nan, Guoxin] Dongguan Key Lab Orthoped Biomat Res & Clin Transf, Dongguan, Peoples R China; [Zheng, Jian; Zhang, Yanting] Chongqing Med Univ, Dept Pediat, Res Inst, Childrens Hosp, Chongqing, Peoples R China"

通信作者："Nan, GX (通讯作者)，Guangdong Med Univ, Dongguan Childrens Hosp, Dongguan Peoples Hosp 8, Dongguan Inst Pediat, Dongguan 523326, Peoples R China.; Nan, GX (通讯作者)，Dongguan Eighth Peoples Hosp, Dongguan, Peoples R China.; Nan, GX (通讯作者)，Dongguan Key Lab Orthoped Biomat Res & Clin Transf, Dongguan, Peoples R China."

来源：JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001199932100001

JCR分区：Q1

影响因子：2.8

年份：2024

卷号：19

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Direct anterior approach; Femoral neck; Femoral head; Pediatric

摘要："Background Femoral neck is one of the high-risk areas for benign tumors and tumor-like lesions. Small range of lesions may also lead to pathological fracture, femoral head necrosis and other serious problems. Purpose To investigate a new minimally invasive surgical approach to resect femoral head and neck lesions in children. Patients and methods Retrospective study of 20 patients with femoral neck and femoral head lesions from February 2019 to March 2023 in our hospital. Among them, 14 were boys and 6 were girls, 17 were femoral neck lesions and 3 were femoral head lesions. The age of the patients ranged from 3.2 to 12.6 years, with a mean of 7.1 years. The patients were divided into group A and group B according to different surgical approaches; group A used the Smith-Peterson approach, Watson-Jones approach or surgical dislocation approach and group B used the DAA. Intra-operatively, incision length, operative time and blood loss were recorded in both groups. Group A consisted of 1 femoral head lesion and 8 femoral neck lesions, including 5 cases of bone cyst and 4 cases of eosinophilic granuloma. Group B consisted of 2 femoral head lesion and 9 femoral neck lesions. A total of 11 patients with different types of disease were included in group B, including bone cysts (3 cases), aneurysmal bone cysts (1 case), eosinophilic granulomas (6 cases), Kaposi's sarcoma (1 case). Results The two groups of patients differed in terms of incision length (P < 0.05), operative blood loss (P < 0.05) and operative time (P < 0.05). At 6-48 months post-operatively, there were no significant differences in function and all patients had good hip function. Conclusion The direct anterior approach is effective for resection of paediatric femoral head and neck lesions. It provides clear exposure of the surgical site, minimal trauma and does not compromise the integrity of the anterior musculature. Level of evidence: III. Conclusion The direct anterior approach is effective for resection of paediatric femoral head and neck lesions. It provides clear exposure of the surgical site, minimal trauma and does not compromise the integrity of the anterior musculature. Level of evidence: III."

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