Xu Chao, Yan Ya-Bo, Zhao Xiong, Wen Xin-Xin, Shang Lei, Huang Lu-Yu, Lei Wei
From Department of Orthopaedics, Xijing Hospital (CX, YBY, XZ, XXW, LYH, WL); and Department of Health Statistics, Faculty of Preventive Medicine, the Fourth Military Medical University, Xi'an, PR China (LS).
Medicine (Baltimore). 2015 Jun;94(23):e932. doi: 10.1097/MD.0000000000000932.
Successful clinical and radiographic outcomes have been reported in patients with unilateral developmental dysplasia of the hip (DDH) following Pemberton pericapsular osteotomy (PPO). However, residual gait deviations are seen in both the affected and unaffected limbs. To date it is not known whether these deviations result in abnormal plantar pressure in such patients. This study investigated this possibility by performing pedobarographic, clinical, and radiographic examinations after PPO in 20 patients (age: 102.5 ± 19.0 months) with unilateral DDH who underwent PPO at 34.2 ± 9.8 months of age. Plantar pressure was evaluated using the Footscan pressure plate (RsScan International, Olen, Belgium). Each foot was subdivided into 10 zones and peak pressure, force-time integral as a percentage of total FTI, and contact time as a percentage of total stance time was estimated. The minimum duration of follow-up was 24 months (mean: 68.3 ± 20.3 months). The data were compared with 20 age- and weight-matched healthy controls. Despite clinical and radiographic examinations showing satisfactory results according to modified McKay and Severin criteria, significant differences in plantar pressure parameters were identified between the affected limbs, the unaffected limbs, and normal controls. No significant differences were found between patients classified as "excellent or good" and those rated as "fair" according to the modified Severin criteria. Pedobarographic results showed the existence of the residual plantar pressure deviations during walking in patients treated with PPO for unilateral DDH. Longer follow-up will be needed to more fully evaluate the effect of these deviations on gait.
据报道，单侧发育性髋关节发育不良（DDH）患者接受彭伯顿关节囊周围截骨术（PPO）后，临床和影像学结果均很成功。然而，患侧和未患侧肢体均存在残余步态偏差。迄今为止，尚不清楚这些偏差是否会导致此类患者足底压力异常。本研究对20例（年龄：102.5±19.0个月）单侧DDH患者进行了研究，这些患者在34.2±9.8个月龄时接受了PPO，术后进行了足底压力测量、临床和影像学检查，以探究这种可能性。使用Footscan压力板（RsScan International，比利时奥伦）评估足底压力。每只脚被细分为10个区域，并估算峰值压力、力-时间积分占总FTI的百分比以及接触时间占总站立时间的百分比。随访最短持续时间为24个月（平均：68.3±20.3个月）。将数据与20名年龄和体重匹配的健康对照进行比较。尽管根据改良的麦凯和塞韦林标准，临床和影像学检查显示结果令人满意，但患侧肢体、未患侧肢体和正常对照之间的足底压力参数存在显著差异。根据改良的塞韦林标准，在分类为“优或良”的患者与评定为“中”的患者之间未发现显著差异。足底压力测量结果显示，接受PPO治疗的单侧DDH患者在行走过程中存在残余足底压力偏差。需要更长时间的随访来更全面地评估这些偏差对步态的影响。
