Sponer Pavel, Pellar David, Kucera Tomás, Karpas Karel
Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic.
Acta Medica (Hradec Kralove). 2006;49(4):215-8. doi: 10.14712/18059694.2017.135.
The purpose of this study was to evaluate the effectiveness of our approach to the spastic hip subluxation and dislocation in children with cerebral palsy. We evaluated 56 hips in our consecutive patients who had been operated on at our department between January 2003 and December 2005. There were done soft-tissue release procedures in 42 hips, osseous reconstructive surgery in 11 hips and osseous palliative surgery in 3 hips. The duration of follow-ups was 1-3 years after surgery. We achieved good result in 15 hips after soft-tissue release, fifteen hips had a fair result, nine a poor result and three a failure. No redislocation was observed after osseous surgery in our patients. Two patients observed no pain after osseous palliative surgery, transient pain in the hip was in one case. In all hips the range of motion (abduction) was increased. The personal hygiene and possibilities of rehabilitation were improved. Childhood is the optimal time to intervene to maximize the function of the patient with cerebral palsy. The musculoskeletal treatment of the child prevents future problems with pain and deformity.
本研究的目的是评估我们针对脑瘫患儿痉挛性髋关节半脱位和脱位的治疗方法的有效性。我们对2003年1月至2005年12月期间在我科接受手术的连续患者中的56个髋关节进行了评估。42个髋关节进行了软组织松解手术,11个髋关节进行了骨性重建手术,3个髋关节进行了骨性姑息手术。术后随访时间为1至3年。软组织松解术后15个髋关节效果良好,15个髋关节效果尚可,9个髋关节效果较差,3个髋关节治疗失败。我们的患者在骨性手术后未观察到再脱位情况。2例患者在骨性姑息手术后无疼痛,1例有髋关节短暂疼痛。所有髋关节的活动范围(外展)均增加。个人卫生状况和康复可能性得到改善。儿童期是进行干预以最大限度提高脑瘫患者功能的最佳时机。对儿童的肌肉骨骼治疗可预防未来的疼痛和畸形问题。