Ucpunar Hanifi, Sevencan Ahmet, Erbas Anil, Ozyalvac Osman Nuri, Akpinar Evren, Bayhan Avni Ilhan
Department of Orthopaedics Surgery and Traumatology, Health Science University Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey.
Department of Orthopedics, Medicana Ataköy Hospital, Istanbul, Turkey.
J Child Orthop. 2023 Dec 24;18(1):79-84. doi: 10.1177/18632521231217330. eCollection 2024 Feb.
Pavlik harness is the most widely used orthosis in the treatment of developmental dysplasia of the hip. The aim of this study was to evaluate the effect of the Pavlik harness on the development of "unaided sitting" and "independent walking" in infants with developmental dysplasia of the hip.
This prospective study, conducted from 2017 to 2020, included infants undergoing Pavlik harness therapy. Inclusion criteria comprised gestational age > 37 weeks, treatment initiation before 6 months of age, and no prior treatment for developmental dysplasia of the hip. We assessed treatment initiation age, treatment duration, and the age of achieving unaided sitting and independent walking.
In the patient group, unaided sitting commenced at a mean age of 6.8 ± 1.6 (range: 4-11) months, while independent walking began at a mean age of 12.7 ± 1.8 (range: 9-18) months. By 15 months, 92% of the patients achieved independent walking. In the control group, unaided sitting occurred at a mean age of 6.1 ± 1.1 (range: 4-8) months, and independent walking at 11.8 ± 1.6 (range: 9-18) months. A significant positive correlation was observed between the duration of Pavlik harness usage and the age of unaided sitting (p < 0.001) and independent walking (p < 0.001).
Our study indicates that Pavlik harness treatment for developmental dysplasia of the hip is generally safe and does not lead to clinically significant delays in unaided sitting and independent walking. However, some minor delays may occur due to extended orthosis use.
level III-prospective cohort study.
帕夫利克吊带是治疗发育性髋关节发育不良最广泛使用的矫形器。本研究的目的是评估帕夫利克吊带对发育性髋关节发育不良婴儿“独坐”和“独立行走”发育的影响。
这项前瞻性研究于2017年至2020年进行,纳入接受帕夫利克吊带治疗的婴儿。纳入标准包括胎龄>37周、6个月龄前开始治疗且既往未接受过发育性髋关节发育不良治疗。我们评估了开始治疗的年龄、治疗持续时间以及实现独坐和独立行走的年龄。
在患者组中,独坐开始的平均年龄为6.8±1.6(范围:4 - 11)个月,而独立行走开始的平均年龄为12.7±1.8(范围:9 - 18)个月。到15个月时,92%的患者实现了独立行走。在对照组中,独坐的平均年龄为6.1±1.1(范围:4 - 8)个月,独立行走的平均年龄为11.8±1.6(范围:9 - 18)个月。观察到帕夫利克吊带使用时间与独坐年龄(p<0.001)和独立行走年龄(p<0.001)之间存在显著正相关。
我们的研究表明,帕夫利克吊带治疗发育性髋关节发育不良总体上是安全的,不会导致独坐和独立行走出现临床上显著的延迟。然而,由于矫形器使用时间延长可能会出现一些轻微延迟。
III级 - 前瞻性队列研究。