Gahleitner Manuel, Haas Christina, Großbötzl Gerhard, Klotz Matthias Christoph Michael, Gotterbarm Tobias, Pisecky Lorenz
Department of Orthopedics and Traumatology, Johannes Kepler University Linz, Kepler University Hospital GmbH, 4020 Linz, Austria.
Department for Orthopaedics and Traumatology, Marienkrankenhaus Soest GmbH, 59494 Soest, Germany.
J Clin Med. 2025 May 16;14(10):3485. doi: 10.3390/jcm14103485.
Hip joint reconstruction is often necessary for children and adolescents with conditions like developmental dysplasia of the hip (DDH), neurogenic dislocation of the hip (NDH), or Legg-Calvé-Perthes disease (LCPD) when non-surgical treatments are ineffective. Post-operative immobilization after hip reconstruction in children is crucial to promote proper healing and reduce the risk of complications. While spica casting has been the traditional method, it can lead to various issues. Foam splinting has emerged as an alternative approach. This study aimed to compare the effectiveness and satisfaction of the patient and the caregivers of spica casting and foam splinting after pelvic osteotomies in young patients with DDH, NDH, and LCPD. A prospective randomized clinical trial included patients aged 3 to 16 undergoing pelvic reconstruction (iliac and proximal femoral osteotomy, open reduction, and soft tissue procedures). Participants were randomized into two groups: one receiving spica casts and the other foam splints, both for a six-week period post-surgery. Quality of life (QOL) assessments like CPCHILD, SF-36, and EQ-5D were conducted using various scores to measure patient and caregiver satisfaction preoperative and at six and twelve weeks postoperative. The surgical techniques were consistent across both groups. : The study included 34 patients, with one excluded due to non-adherence. The spica cast group experienced statistically significant declines in QOL scores, while the foam splint group showed decreases that were not statistically significant. Complications were reported in 11 patients, with a higher prevalence in the spica cast group. : The foam splint group demonstrated superior satisfaction levels and fewer complications, which leads to the conclusion that foam splinting should be the preferred option to spica casting for post-operative immobilization in these cases.
对于患有发育性髋关节发育不良（DDH）、神经性髋关节脱位（NDH）或Legg-Calvé-Perthes病（LCPD）等疾病且非手术治疗无效的儿童和青少年，髋关节重建通常是必要的。儿童髋关节重建术后的固定对于促进正确愈合和降低并发症风险至关重要。虽然髋人字石膏一直是传统方法，但它可能导致各种问题。泡沫夹板已成为一种替代方法。本研究旨在比较DDH、NDH和LCPD年轻患者骨盆截骨术后髋人字石膏固定和泡沫夹板固定在有效性以及患者和护理人员满意度方面的差异。一项前瞻性随机临床试验纳入了3至16岁接受骨盆重建（髂骨和股骨近端截骨、切开复位和软组织手术）的患者。参与者被随机分为两组：一组接受髋人字石膏固定，另一组接受泡沫夹板固定，两组均在术后六周使用。使用CPCHILD、SF-36和EQ-5D等生活质量（QOL）评估工具的各种评分来衡量患者和护理人员术前以及术后六周和十二周的满意度。两组的手术技术一致。该研究纳入了34名患者，其中一名因未遵守规定而被排除。髋人字石膏固定组的QOL评分出现了统计学上的显著下降，而泡沫夹板固定组的下降没有统计学意义。11名患者报告了并发症，髋人字石膏固定组的发生率更高。泡沫夹板固定组表现出更高的满意度且并发症更少，由此得出结论，在这些病例中，泡沫夹板固定应是术后固定优于髋人字石膏固定的首选方法。
