Harding M G, Harcke H T, Bowen J R, Guille J T, Glutting J
Alfred I. duPont Institute, Wilmington, Delaware 19899, USA.
J Pediatr Orthop. 1997 Mar-Apr;17(2):189-98. doi: 10.1097/00004694-199703000-00010.
We studied the outcome of ultrasound-monitored Pavlik harness treatment of 47 infants (nine boys and 38 girls) with 55 frankly dislocated hips documented by dynamic ultrasonography. The success and failure groups were of similar ultrasound status (hip-status score) at the time of initial examination, but a significant difference emerged at the 7- and 14-day examinations. Detection of frank dislocation and institution of treatment with the Pavlik harness within 3 weeks of birth increased the probability of a successful result. Of 33 infants (27 girls and six boys) with 41 dislocated hips who were seen before the age of 21 days, 26 (63%) hips were reducible in the Pavlik harness alone, and 15 (37%) hips were irreducible and required a subsequent procedure to achieve reduction. Fourteen infants (three boys and 11 girls) with 14 dislocated hips were first seen after the age of 21 days. Three (20%) were successfully treated in the Pavlik harness alone, and 11 (80%) required further treatment. In our opinion, persistent dislocation without improvement after 3 weeks of treatment in the Pavlik harness mandates discontinuation of use of this device. No anatomic factors were seen at the time of the initial ultrasound examination that permitted prediction of those hips likely to succeed or fail treatment with the Pavlik harness.
我们研究了47例婴儿（9例男婴，38例女婴）超声监测下帕夫利克吊带治疗的结果，这些婴儿经动态超声检查证实有55例髋关节完全脱位。成功组和失败组在初次检查时超声状况（髋关节状况评分）相似，但在7天和14天检查时出现了显著差异。出生后3周内发现完全脱位并使用帕夫利克吊带治疗增加了获得成功结果的可能性。在21日龄前就诊的33例婴儿（27例女婴，6例男婴）中，41例髋关节脱位，其中26例（63%）髋关节仅用帕夫利克吊带即可复位，15例（37%）髋关节无法复位，需要后续手术才能复位。14例婴儿（3例男婴，11例女婴）有14例髋关节脱位，首次就诊时年龄超过21日龄。其中3例（20%）仅用帕夫利克吊带治疗成功，11例（80%）需要进一步治疗。我们认为，在帕夫利克吊带治疗3周后仍持续脱位且无改善，则应停止使用该装置。在初次超声检查时，未发现任何解剖学因素可预测哪些髋关节使用帕夫利克吊带治疗可能成功或失败。
