Baumann Anthony N, Ndjonko Laura C M, Schoenecker Jonathan G, Baldwin Keith D
College of Medicine, Northeast Ohio Medical University, Rootstown.
Department of Rehabilitation Services, University Hospitals, Cleveland, OH.
J Pediatr Orthop. 2024 Jan 1;44(1):e97-e105. doi: 10.1097/BPO.0000000000002563. Epub 2023 Nov 10.
Pediatric traumatic hip dislocations are a rare condition that can have devastating short and/or long-term outcomes and associated pathologies (APs), including associated injuries (AIs) and long-term adverse events (LTAEs), with negative long-term sequelae. Currently, there are little data that exist on the rate of APs, with the most notable being avascular necrosis (AVN), for pediatric traumatic hip dislocations. The purpose of this systematic review is to evaluate the outcome relative frequency of dislocation direction, reduction type, and rate of APs for traumatic hip dislocations in the pediatric population.
A systematic review on the topic of traumatic hip dislocations in the pediatric population was performed using PubMed, ScienceDirect, Web of Science, CINAHL, and MEDLINE databases from database inception to March 30, 2023. Inclusion criteria was full-text English articles, addressed traumatic hip dislocations, and pediatric patients (<18 y old).
A total of 24 articles (n=575 patients) met final inclusion criteria from a total of 219 articles retrieved from the initial search. For the average age of the included patients with reported age (n=433 patients), the frequency weighted mean was 9.50 years±1.75 years with a frequency weighted mean follow-up time of 74.05 months ±45.97 months (n=399 patients). The most common dislocation direction was posterior (86.4%), the most common treatment type was closed reduction (84.5%), AVN was the most common type of LTAEs (15.5% of APs), and labral/capsular injuries and acetabular fractures were the most common type of AIs (14.0% and 9.4% of APs, respectively). There were a combined total of 414 APs (72%) out of 575 total patients.
Pediatric traumatic hip dislocations are associated with a high rate of AIs and LTAEs (72%, 414 APs out of 575 patients). AVN, labral/capsular injuries, and acetabular fractures are the most common APs after pediatric traumatic hip dislocations. Pediatric hip dislocations are usually posterior and commonly managed through closed reduction.
III, Systematic Review.
小儿创伤性髋关节脱位是一种罕见病症，可产生严重的短期和/或长期后果及相关病变（APs），包括合并伤（AIs）和长期不良事件（LTAEs），会导致长期负面后遗症。目前，关于小儿创伤性髋关节脱位的APs发生率的数据很少，其中最显著的是股骨头缺血性坏死（AVN）。本系统评价的目的是评估小儿人群创伤性髋关节脱位的脱位方向、复位类型及APs发生率的相对结局频率。
使用PubMed、ScienceDirect、Web of Science、CINAHL和MEDLINE数据库，对小儿人群创伤性髋关节脱位这一主题进行系统评价，检索时间从数据库建立至2023年3月30日。纳入标准为英文全文文章，涉及创伤性髋关节脱位及小儿患者（<18岁）。
从初步检索获得的219篇文章中，共有24篇文章（n = 575例患者）符合最终纳入标准。对于报告了年龄的纳入患者的平均年龄（n = 433例患者），频率加权平均数为9.50岁±1.75岁，频率加权平均随访时间为74.05个月±45.97个月（n = 399例患者）。最常见的脱位方向是后脱位（86.4%），最常见的治疗类型是闭合复位（84.5%），AVN是最常见的LTAEs类型（占APs的15.5%），盂唇/关节囊损伤和髋臼骨折是最常见的AIs类型（分别占APs的14.0%和9.4%）。575例患者中共有414例APs（72%）。
小儿创伤性髋关节脱位与高发生率的AIs和LTAEs相关（72%，575例患者中有414例APs）。AVN、盂唇/关节囊损伤和髋臼骨折是小儿创伤性髋关节脱位后最常见的APs。小儿髋关节脱位通常为后脱位，且通常通过闭合复位进行处理。
III，系统评价。
