Lefort G, Belouadah M, Pillon-Persyn M A, Lefebvre F, Poli-Merol M L, Daoud S
American Memorial Hospital, Reims.
Rev Chir Orthop Reparatrice Appar Mot. 1995;81(7):609-15.
The management of DDH in infants less than one year old is not yet definite. Many ambulant therapeutic methods are described and Pavlik's harness is widely employed. The use of Petit's splints is less well known and we report our experience with 169 cases.
Between 1973 and 1991, Petit's splints were used in 112 cases, following abduction cushions in 55 cases and after Pavlik's harness in 2 cases. 103 hips were dislocated but reducible. This permitted progressive abduction of the hips in order to obtain the reduction of the dislocation and to ensure stabilization by retraction of the slack articular capsule.
Only 8 dislocations (4,7 per cent) couldn't be reduced by this procedure and necessitated another treatment. Hips were normal after 5 years of follow up in 118 cases and there were 43 residual dysplasias. 6 post reductional avascular necrosis (3,7 per cent) were recorded as a complication of this method among which only one was a serlous from.
This ambulatory method for treatment of congenital hip dislocation seems to be forsaken by many authors. Nevertheless its effectiveness has been demonstrated with a complication rate lower than with Pavlik's harness procedure.
一岁以下婴儿发育性髋关节发育不良(DDH)的治疗方法尚无定论。有许多非手术治疗方法被描述,帕夫利克吊带被广泛应用。佩蒂特夹板的使用鲜为人知,我们报告169例使用该夹板的经验。
1973年至1991年间,112例使用佩蒂特夹板,55例使用外展垫,2例在使用帕夫利克吊带后使用。103个髋关节脱位但可复位。这允许髋关节逐渐外展,以实现脱位复位,并通过松弛关节囊的回缩确保稳定。
该方法仅8例脱位(4.7%)无法复位,需要其他治疗。118例随访5年后髋关节正常,43例有残余发育不良。记录到6例复位后缺血性坏死(3.7%)作为该方法的并发症,其中仅1例严重。
这种非手术治疗先天性髋关节脱位的方法似乎被许多作者摒弃。然而,其有效性已得到证实,并发症发生率低于帕夫利克吊带治疗方法。