Department of Orthopaedics; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders (Chongqing); China International Science and Technology Cooperation base of Child development and Critical Disorders; Children's Hospital of Chongqing Medical University, 136 Zhongshan Er Road, Yuzhong District, Chongqing, 400014, People's Republic of China.
J Orthop Surg Res. 2020 Dec 2;15(1):579. doi: 10.1186/s13018-020-02098-3.
The purpose of this study was to evaluate the efficacy of closed reduction (CR) in the treatment of developmental dysplasia of the hip (DDH) and to investigate risk factors associated with CR failure and avascular necrosis (AVN) occurrence in follow-ups.
The study retrospectively included 110 patients and 138 hips with DDH diagnosis that underwent closed reduction between February 2012 and November 2015 in our single tertiary medical institution. The failure rate of CR and the underlying risk factors were evaluated. Meanwhile, the incidence of AVN and the related risk factors among the successful CR cases were assessed.
The overall failure rate of DDH treated by CR in the present study was 31.16% (43/138). Risk factors for the CR failure were older age at the time of CR (≥ 18.35 month), large medical interval before CR (≥ 35.35 mm), and severer dislocation of the affected hip (IDHI grades III and IV). The incidence of AVN was 8.33% (6/72) in patients with successful CR at the last follow-up. No significant risk factors had been established in the present study that associated with the AVN occurrence.
For the treatment of DDH with CR, patients with younger age might achieve better outcomes; early diagnosis and early treatment might be the key point in the DDH treatment.
本研究旨在评估闭合复位（CR）治疗发育性髋关节发育不良（DDH）的疗效，并探讨随访中与 CR 失败和缺血性坏死（AVN）发生相关的风险因素。
本研究回顾性纳入了 2012 年 2 月至 2015 年 11 月期间在我院单中心接受闭合复位治疗的 110 例 138 髋 DDH 患者。评估 CR 失败的发生率和潜在的风险因素。同时，评估成功 CR 病例中 AVN 的发生率和相关的风险因素。
本研究中 CR 治疗 DDH 的总体失败率为 31.16%（43/138）。CR 失败的风险因素包括 CR 时年龄较大（≥18.35 个月）、CR 前医疗间隔时间较长（≥35.35mm）和髋关节受累侧脱位较重（IDHI 分级 III 和 IV）。在最后一次随访时，成功 CR 的患者中 AVN 的发生率为 8.33%（6/72）。本研究未确定与 AVN 发生相关的显著风险因素。
对于 CR 治疗 DDH，年龄较小的患者可能会取得更好的结果；早期诊断和早期治疗可能是 DDH 治疗的关键。
