Departments of Ultrasound.
Pediatric Orthopaedics, Beijing Jishuitan Hospital, Capital Medical University, The 4th Clinical College, Peking University, Beijing, China.
J Pediatr Orthop B. 2024 Jul 1;33(4):314-321. doi: 10.1097/BPB.0000000000001111. Epub 2023 Aug 7.
To assess changes in the α and β angle with brace treatment in DDH classified as Type Graf IIc, D, III, and IV; to study the α angle threshold that can predict the treatment effect; to analyze the effective rate in different groups. A retrospective study was conducted on children from 2013 to 2018 with Graf type IIc and greater diagnosed with ultrasound (US). Brace therapy was applied to 356 patients, with 423 affected hips (Graf IIc: 202 hips; Graf D: 17 hips; Graf III: 118 hips; and Graf IV: 86 hips). For follow-up efficacy analyses using US, X-ray and clinical examination, based on the success of early treatment of the brace, the outcomes were divided into 'effective' and 'noneffective' groups. The statistical results showed that the α angle increased ( P < 0.05) and the β angle decreased ( P < 0.05). When α≥43°, the accuracy of success with early treatment was 95.95%. The overall effective rate of bracing treatment was 74.70%. Children with α ≥ 43° are recommended to receive brace therapy as soon as possible and demonstrate the best effects. The effective rate varies across different Graf types and the age at treatment initiation. Brace therapy is more effective for Graf IIc and D hips compared to Graf III and IV.
评估在 Graf IIc、D、III 和 IV 型发育性髋关节发育不良（DDH）中使用支具治疗后 α 角和 β 角的变化；研究能够预测治疗效果的 α 角阈值；分析不同组别中的有效率。对 2013 年至 2018 年经超声（US）诊断为 Graf Ⅱc 型以上的儿童进行回顾性研究。356 例患者应用支具治疗，共 423 髋受累（Graf IIc：202 髋；Graf D：17 髋；Graf III：118 髋；Graf IV：86 髋）。根据支具早期治疗的成功，使用 US、X 射线和临床检查进行随访疗效分析，将结果分为“有效”和“无效”组。统计结果显示，α 角增加（P ＜0.05），β 角减小（P ＜0.05）。当 α≥43°时，早期治疗成功的准确率为 95.95%。支具治疗的总有效率为 74.70%。建议α≥43°的患儿尽快接受支具治疗，以获得最佳效果。不同 Graf 类型和治疗起始年龄的有效率不同。与 Graf III 和 IV 型相比，Graf IIc 和 D 型髋关节的支具治疗效果更好。
