Chen Qiang, Deng Yu, Fang Bin
Acta Orthop Belg. 2015 Sep;81(3):375-83.
This study aimed to evaluate the outcome of one-stage treatment for developmental dysplasia of the hip (DDH) in patients after walking age. A Total of 58 children (67 hips) were retrospectively investigated to assess the efficacy and safety of one-stage treatment of developmental dysplasia of the hip (DDH) in children from 1.5 to 6 years of age with a mean follow-up of 4.00±0.43 (range 3-6.8) years. Eleven (19%) were male, forty-seven (81%) were female. Our method consisted of open reduction, Salter innominate osteotomy, femoral shortening and derotation. The patients were distributed into three groups according to the age at which they were operated: 12 (20.7%) patients with 12 hips (17.9%) were operated between 1.5 and 2 years of age (Group I), 35 (60.3%) patients with 44 hips (65.7%) were operated between 2 and 4 years (Group II), 11 (19%) patients with 11 hips (16.4%) were operated between 4 and 6 years (Group III). Clinical and radiological assessment at final follow-up showed that the outcome was not significantly different between group I and group II. But clinically, there was significant difference between group I and group III, and also between group II and group III. Although in the outcome of radiological assessment there was no significant difference between group I and group II compared with group III. The rate of avascular nerosis in group I was lower than in group II or in group III. Children with DDH between 1.5 and 6 years of age were treated successfully with one-stage treatment, but in our hands the best age at surgery is before 4 years of age.
本研究旨在评估步行年龄后发育性髋关节发育不良(DDH)患者一期治疗的效果。回顾性调查了共58例儿童(67髋),以评估1.5至6岁儿童发育性髋关节发育不良(DDH)一期治疗的有效性和安全性,平均随访4.00±0.43(范围3 - 6.8)年。11例(19%)为男性,47例(81%)为女性。我们的方法包括切开复位、Salter骨盆截骨术、股骨缩短和旋转。根据手术时的年龄将患者分为三组:12例(20.7%)患者的12髋(17.9%)在1.5至2岁之间接受手术(I组),35例(60.3%)患者的44髋(65.7%)在2至4岁之间接受手术(II组),11例(19%)患者的11髋(16.4%)在4至6岁之间接受手术(III组)。末次随访时的临床和影像学评估显示,I组和II组的结果无显著差异。但在临床上,I组和III组之间以及II组和III组之间存在显著差异。虽然在影像学评估结果中,I组和II组与III组相比无显著差异。I组的无血管坏死率低于II组或III组。1.5至6岁的DDH患儿一期治疗成功,但在我们的经验中,最佳手术年龄是在4岁之前。