Department for Orthopedics and Traumatology, Kepler University Hospital GmbH, Johannes Kepler University Linz, 4040 Linz, Austria.
Medicina (Kaunas). 2022 Jan 28;58(2):206. doi: 10.3390/medicina58020206.
This study shows a sufficient treatment with the Pavlik harness for all patients through all phases of developmental dysplasia of the hip (DDH) if there is a strict regime. : There was an ultrasound measurement stage of IIc or worse (D, IIIa/b, IVa/b) in 159 out of 7372 newborns between 1995 and 2006 (2.15%). This is an indication for treatment with the Pavlik harness. Overall, 203 dysplastic hips were treated initially with our regime. After detection, we started the application of the Pavlik harness immediately in the 'human position'. There were appointments every 10-14 days to check the setting combined with ultrasound controls. The treatment stopped if a mature, well-developed picture of both hips was seen when compared to Graf type Ia/b. Afterwards, an X-ray control was carried out at about one year of age. : 159 newborns with 203 dislocated hips were treated. The distribution following Graf's classification was as follows: 150 type IIc (73.9%), 18 type D (8.9%), 31 type IIIa/b (15, 3%) and 4 type IV (1.9%). To summarize, there were 150 (73.9%) type IIc hips at risk of developing a dislocation but also 53 hips (26.1%) which were already dislocated at the moment of birth. There was a loss to follow-up in three patients (1.8%), and the therapy had to be changed in six cases. There was no degradation in our study population during therapy. The treatment with the Pavlik harness of DDH at every stage in newborns was possible and showed good results in 189 hips.
本研究表明，如果采用严格的治疗方案，所有发育性髋关节发育不良（DDH）患者在各个阶段都可以通过 Pavlik 吊带获得充分的治疗：在 1995 年至 2006 年间的 7372 名新生儿中，有 159 名（2.15%）处于 IIc 期或更差的超声测量阶段（D、IIIa/b、IVa/b）。这是使用 Pavlik 吊带治疗的指征。总体而言，我们的治疗方案最初治疗了 203 个发育不良的髋关节。发现后，我们立即在“人位”开始应用 Pavlik 吊带。每 10-14 天进行一次随访，以检查结合超声控制的设置。当与 Graf 类型 Ia/b 相比，看到两个髋关节成熟且发育良好的图像时，治疗就会停止。之后，大约在一岁时进行 X 射线检查。：159 名新生儿中有 203 个髋关节脱位，采用 Graf 分类如下：150 型 IIc（73.9%），18 型 D（8.9%），31 型 IIIa/b（15.3%）和 4 型 IV（1.9%）。总结一下，有 150 个（73.9%）IIc 型髋关节有脱位的风险，但也有 53 个（26.1%）髋关节在出生时已经脱位。有 3 名患者（1.8%）失访，6 例患者需要改变治疗方案。在治疗过程中，我们的研究人群没有出现病情恶化。在新生儿的各个阶段，对 DDH 进行 Pavlik 吊带治疗是可行的，在 189 个髋关节中取得了良好的效果。
