Kraus Tanja, Hammerschmid Anita, Guggenberger Bernhard, Novak Michael, Schappacher-Tilp Gudrun, Svehlik Martin
Medical University of Graz, Graz, Austria.
FH JOANNEUM - University of Applied Sciences, Graz, Austria.
Arch Orthop Trauma Surg. 2024 Dec 27;145(1):94. doi: 10.1007/s00402-024-05715-6.
Developmental dysplasia of the hip is a prevalent condition in newborns. However, predicting the duration of conservative treatment remains challenging. This study aimed to determine the duration of treatment more precisely by analyzing associated factors. We conducted a retrospective analysis and developed a linear regression model based on 503 patients treated at our institution over the last 10 years. A linear regression model (GLM) was used for predicting treatment duration (df residuals 371, df model 3, Pearson Chi2 78.9, Number of iterations 15). The baseline scenario thereby feature a child with an average age at the beginning of treatment (35th day of life), both sides pathologically affected, and a minimum alpha angle of 29 degrees. The GLM identified age at treatment onset, alpha angle, and bilaterality as significant predictors of treatment duration. A four-week delay in treatment initiation extended the duration by one week, while a 5-degree increase in the alpha angle reduced it by two weeks. Bilaterality added 19 days to treatment duration. However, sex and clinical hip instability did not significantly affect the treatment time. These findings enable the calculation of treatment duration based on identified factors, potentially improving the management and planning of conservative therapies for developmental dysplasia of the hip in newborns.
发育性髋关节发育不良在新生儿中是一种常见病症。然而,预测保守治疗的持续时间仍然具有挑战性。本研究旨在通过分析相关因素更精确地确定治疗持续时间。我们进行了一项回顾性分析,并基于过去10年在我们机构接受治疗的503例患者建立了线性回归模型。使用线性回归模型(广义线性模型)预测治疗持续时间(自由度残差371,自由度模型3,皮尔逊卡方值78.9,迭代次数15)。基线情况为治疗开始时平均年龄(出生第35天)的儿童,双侧均受病理影响,最小阿尔法角为29度。广义线性模型确定治疗开始时的年龄、阿尔法角和双侧性是治疗持续时间的显著预测因素。治疗开始延迟四周会使持续时间延长一周,而阿尔法角增加5度会使其减少两周。双侧性使治疗持续时间增加19天。然而,性别和临床髋关节不稳定对治疗时间没有显著影响。这些发现能够根据确定的因素计算治疗持续时间,可能改善新生儿发育性髋关节发育不良保守治疗的管理和规划。