Kokavec Milan, Makai Frantisek, Olos Michael, Bialik Viktor
1st Ortopedicka Klinika FN, LFUK, SZU, Ruzinovska 6, Bratislava, Slovakia.
Arch Orthop Trauma Surg. 2006 Mar;126(2):73-6. doi: 10.1007/s00402-005-0086-1. Epub 2006 Jan 27.
This retrospective study of the early work of Arnold Pavlik in the treatment of developmental dysplasia of the hip proves the success of his method in eradicating avascular necrosis (AVN) resulting from other modes of treatment. Authors analyzed some 100 charts of children treated for CDH, as it was known at that time, between 1969 and 1981, and assessed the influence of gender, clinical stability, severity of X-ray pathology and age at which treatment was started, according to duration, outcome of treatment and rate of AVN. Of the 100 children with 134 treated pathological hips, 62 children with 86 pathological hips were treated exclusively by Pavlik's method. Length of treatment for the 86 hips successfully treated by Pavlik's method only was an average of 6 months. No AVN was found for any hip treated by Pavlik's method only, including dislocated hips. The 65% of failure rate was for dislocated hips only. Late onset and prolonged duration of treatment using Pavlik's method contributed to relative high failure rate followed by AVN. This leads to the conclusion that Pavlik's method is safe and accurate for all dysplastic and subluxated hips, along with the vast majority of dislocated hips.
这项对阿诺德·帕夫利克早期治疗发育性髋关节发育不良工作的回顾性研究证明了他的方法在根除其他治疗方式导致的股骨头缺血性坏死(AVN)方面的成功。作者分析了1969年至1981年间约100例当时被称为先天性髋关节脱位(CDH)患儿的病历,并根据治疗持续时间、治疗结果和AVN发生率,评估了性别、临床稳定性、X线病理严重程度以及开始治疗时的年龄的影响。在100例患有134个病理性髋关节的患儿中,62例患有86个病理性髋关节的患儿仅接受了帕夫利克方法的治疗。仅用帕夫利克方法成功治疗的86个髋关节的平均治疗时长为6个月。仅用帕夫利克方法治疗的任何髋关节,包括脱位髋关节,均未发现AVN。65%的失败率仅针对脱位髋关节。帕夫利克方法治疗的延迟开始和持续时间延长导致相对较高的失败率,随后出现AVN。这得出的结论是,帕夫利克方法对于所有发育不良和半脱位髋关节以及绝大多数脱位髋关节都是安全且准确的。