Suzuki S, Kashiwagi N, Kasahara Y, Seto Y, Futami T
Department of Orthopaedics, Shiga Medical Centre for Children, Japan.
J Bone Joint Surg Br. 1996 Jul;78(4):631-5.
We analysed the incidence of avascular necrosis in 101 hips of 90 infants with congenital dislocation treated with Pavlik harness and followed up for more than one year. Using ultrasonography in the flexed-abducted position the hips were classified as type A when the femora head was displaced posteriorly, but within the socket and making contact with the posterior inner wall of the acetabulum; type B when it was in contact with the posterior margin of the acetabulum, with its centre at this level or anterior to it; and type C when it was displaced out of the socket, with its centre posterior to the posterior rim of the acetabulum. Eighty-seven hips were reduced by the harness (86%), and seven of these developed avascular necrosis (8%). All 69 hips with type-A dislocation were reduced and only one (1.4%) showed slight avascular necrosis. Eighteen (78.3%) of 23 hips with type-B dislocation were reduced, and six developed avascular necrosis (33.3%). In one hip, the femoral head was severely damaged. None of the nine hips with type-C dislocation was reduced in the harness. We concluded that the Pavlik harness is indicated for type-A but not for type-B or type-C dislocations.
我们分析了90例先天性髋关节脱位婴儿使用 Pavlik 吊带治疗并随访超过一年的101个髋关节的无血管性坏死发生率。在髋关节外展屈曲位使用超声检查，当股骨头向后移位但仍在髋臼内并与髋臼后壁接触时，髋关节被分类为 A 型；当股骨头与髋臼后缘接触，其中心位于该水平或前方时为 B 型；当股骨头移出髋臼，其中心位于髋臼后缘后方时为 C 型。87个髋关节通过吊带复位（86%），其中7个发生无血管性坏死（8%）。所有69个 A 型脱位髋关节均复位，仅有1个（1.4%）显示轻微无血管性坏死。23个 B 型脱位髋关节中有18个（78.3%）复位，6个发生无血管性坏死（33.3%）。在1个髋关节中，股骨头严重受损。9个 C 型脱位髋关节中无一通过吊带复位。我们得出结论，Pavlik 吊带适用于 A 型脱位，但不适用于 B 型或 C 型脱位。
