针对6个月以下发育性髋关节脱位婴儿的人体定位支具与帕夫利克吊带：治疗效果比较
Human Position Brace Versus Pavlik Harness for Infants Under 6 Months of Age With Developmental Dislocation of the Hip: A Comparison of Therapeutic Efficacy.
作者信息
Gou Pan, Zhang Yuan, Wu Jun, Li Jun, Li Xiang, Li Ming, Liu Xing
机构信息
Department of Orthopedic, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China.
出版信息
J Pediatr Orthop. 2021 Aug 1;41(7):e545-e549. doi: 10.1097/BPO.0000000000001862.
BACKGROUND
For 0- to 6-month-old patients with developmental dislocation of the hip, the likelihood of Pavlik harness treatment failure may be increased. The human position brace is an available option. We aimed to compare therapeutic efficacy between the Pavlik harness and human position brace.
METHODS
We included 87 patients (106 hips) in the human position brace group and 47 patients (62 hips) in the Pavlik harness group. Clinical and radiologic outcomes were recorded and compared, respectively.
RESULTS
The mean follow-up was 17.73±14.56 months (range, 5 to 56 mo). Human position brace produced higher success rates (65.1% vs. 43.5%; P=0.006) and had significant advantages in the 4 to 6 months group (P<0.001). According to the last follow-up x-ray, when compared with that of the Pavlik harness group, upper space was larger (P=0.032) and inner space was smaller (P<0.001) in the human position brace group.
CONCLUSIONS
Given the increased success rates and better hip development by the last follow-up, the human position brace could be considered as an alternative, or even as the first choice for 4- to 6-month-old infants with developmental dislocation of the hip to address the specific deficits of Pavlik harness.
LEVEL OF EVIDENCE
Level III-retrospective comparison.
背景
对于0至6个月大的发育性髋关节脱位患者，使用 Pavlik 吊带治疗失败的可能性可能会增加。人体姿势支具是一种可行的选择。我们旨在比较 Pavlik 吊带和人体姿势支具的治疗效果。
方法
我们纳入了人体姿势支具组的87例患者（106髋）和 Pavlik 吊带组的47例患者（62髋）。分别记录并比较临床和放射学结果。
结果
平均随访时间为17.73±14.56个月（范围5至56个月）。人体姿势支具的成功率更高（65.1% 对43.5%；P = 0.006），并且在4至6个月组中具有显著优势（P < 0.001）。根据最后一次随访的X线片，与 Pavlik 吊带组相比，人体姿势支具组的上方间隙更大（P = 0.032），内侧间隙更小（P < 0.001）。
结论
鉴于成功率提高且末次随访时髋关节发育更好，人体姿势支具可被视为一种替代方案，甚至可作为4至6个月大发育性髋关节脱位婴儿的首选，以解决 Pavlik 吊带的特定缺陷。
证据级别
III级——回顾性比较。
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