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保守治疗后发育异常髋关节的发展(作者译)

[The development of the dysplastic hip joint after conservative treatment (author's transl)].

作者信息

Reichelt A, Ritter R

出版信息

Arch Orthop Unfallchir. 1975 Jul 28;82(4):285-97. doi: 10.1007/BF00418924.

Abstract

The roentgenograms were evaluated of 220 patients (159 female, 61 male) with 61 luxations, 77 subluxations and 203 dysplastic hip joints which were a maximum of 2 years old during treatment and had been under observation for between 2 and 17 11/12 years. The CCD-, CE- and Ac-angles were measured. 1. The CCD-angle develops relatively independent of the therapy for the first few months. In the long term, the abduction treatment leads to a straightening up of the femoral neck. Here a physiological component apparently has an effect which reduces the straightening after several years. 2. The CE-angle rapidly becomes enlarged during the first few months, later the rate is slower. Three years after treatment began, the CE-angle was normal in 83.6% of the patients. 3. The Ac-angle decreases rapidly during the first 6 months. Three years after the beginning of treatment, 65.7% of the patients had a norm of less than 20 degrees. 4. All angles show a positive correlation of their beginning and end values i.e. light dysplasias have the best prognosis. 5. The monotherapy with a spreader pant showed a particular advantage over the combination treatment and plaster fixation. 6. The best result was achieved with treatment beginning before the age of 6 months. Boys showed a better tendency to heal. A difference in sides could not be shown.

摘要

对220例患者(159例女性,61例男性)的X线片进行了评估,这些患者有61例髋关节脱位、77例半脱位和203例发育不良髋关节,治疗时年龄最大为2岁,观察时间为2至17又11/12年。测量了CCD角、CE角和Ac角。1. 在最初几个月,CCD角的发育相对独立于治疗。从长期来看,外展治疗会使股骨颈变直。显然,这里有一个生理因素起作用,几年后会减少变直程度。2. 在最初几个月,CE角迅速增大,之后速度变慢。治疗开始三年后,83.6%的患者CE角正常。3. 在最初6个月,Ac角迅速减小。治疗开始三年后,65.7%的患者Ac角小于20度。4. 所有角度的起始值和终值都呈正相关,即轻度发育不良预后最佳。5. 与联合治疗和石膏固定相比,使用撑开裤单一疗法显示出特别的优势。6. 在6个月龄前开始治疗效果最佳。男孩愈合趋势更好。未显示出左右侧差异。

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