Walton M J, Isaacson Z, McMillan D, Hawkes R, Atherton W G
Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK.
J Bone Joint Surg Br. 2010 Jul;92(7):1013-6. doi: 10.1302/0301-620X.92B7.23513.
We present the results of treatment of developmental dysplasia of the hip in infancy with the Pavlik harness using a United Kingdom screening programme with ultrasound-guided supervision. Initially, 128 consecutive hips in 77 patients were reviewed over a 40-month period; 123 of these were finally included in the study. The mean age of the patients at the start of treatment was five weeks (1 to 12). All hips were examined clinically and monitored with ultrasound scanning. Failure of treatment was defined as an inability to maintain reduction with the harness. All hips diagnosed with dysplasia or subluxation but not dislocation were managed successfully in the harness. There were 43 dislocated hips, of which 39 were reducible, but six failed treatment in the harness. There were four dislocated but irreducible hips which all failed treatment in the harness. One hip appeared to be successfully treated in the harness but showed persistent radiological dysplasia at 12 and 24 months. Grade 1 avascular necrosis was identified radiologically in three patients at 12 months.
我们展示了在英国一项超声引导监测的筛查项目中，使用 Pavlik 吊带治疗婴儿期发育性髋关节发育不良的结果。最初，在 40 个月的时间里对 77 例患者的 128 个髋关节进行了连续评估；其中 123 个最终纳入研究。治疗开始时患者的平均年龄为 5 周（1 至 12 周）。所有髋关节均进行了临床检查，并通过超声扫描进行监测。治疗失败定义为无法通过吊带维持复位。所有诊断为发育不良或半脱位但未脱位的髋关节均在吊带治疗中成功处理。有 43 个脱位髋关节，其中 39 个可复位，但 6 个在吊带治疗中失败。有 4 个脱位但不可复位的髋关节，均在吊带治疗中失败。1 个髋关节在吊带治疗中似乎成功，但在 12 个月和 24 个月时显示持续的放射学发育不良。12 个月时，3 例患者经放射学检查发现 1 级缺血性坏死。
