Docking phenomenon and subsequent acetabular development after gradual reduction using overhead traction for developmental dysplasia of the hip over six months of age.
Docking phenomenon and subsequent acetabular development after gradual reduction using overhead traction for developmental dysplasia of the hip over six months of age.
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DOI：
10.1302/1863-2548.15.210143
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发表时间：
2021-12-01
期刊：
影响因子：
--
通讯作者：
Hattori T
中科院分区：
文献类型：
--
作者：
Kaneko H;Kitoh H;Kitamura A;Sawamura K;Hattori T
本研究旨在探讨发育性髋关节发育不良 (DDH) 牵引逐渐复位 (GR) 后股骨头与髋臼的对接以及对后续髋臼发育的影响。回顾性分析了 40 例 DDH 患者（42 髋）接受过头牵引和人字形铸造进行 GR 的情况。在人字形铸造后立即和五周的 MRI 之间比较了盂唇内翻的存在以及股骨髋臼的冠状距离和轴向距离 (FAD)。随访 MRI 比较了盂唇内翻髋关节（残余组）和盂唇形状正常髋关节（标准化组）前后骨盆 X 片上髋臼指数的变化。复位时的平均年龄为 13.1 个月（7 至 33 岁），平均随访时间为 7.7 年（4 至 11 岁）。在 MRI 扫描之间，盂唇内翻和 FAD 的发生率显着下降（所有 p 值 < 0.001），并且之前的 Pavlik 安全带故障对这些下降没有负面影响。残差组三岁和五岁时的髋臼指数显着大于标准化组（p 值均 < 0.001）。残余髋臼发育不良的发生率为 84.2%，而正常化组为 34.8% (p = 0.002)。对于 6 个月至 3 岁的 DDH 儿童，使用牵引进行 GR 后，在角位铸造过程中可能会出现对接现象。石膏去除时剩余的内翻盂唇可能会对随后的髋臼发育产生负面影响。三——回顾性比较研究
This study aimed to explore the docking of the femoral head into the acetabulum after gradual reduction (GR) using traction for developmental dysplasia of the hip (DDH) and the impact on subsequent acetabular development. A total of 40 patients with DDH (42 hips) undergoing GR using overhead traction and spica casting were retrospectively reviewed. The presence of inverted labrum and the coronal and axial femoral-acetabular distances (FADs) were compared between MRI immediately and five weeks after spica casting. The change in the acetabular index on anteroposterior pelvic radiographs were compared between hips with inverted labrum (residual group) and with normally-shaped labrum (normalized group) on follow-up MRI. The mean age at reduction was 13.1 months (7 to 33) and the mean follow-up duration was 7.7 years (4 to 11). The rate of inverted labrum and the FADs significantly decreased between the MRI scans (all p-values < 0.001), and previous Pavlik harness failure had no negative effect on these decreases. The acetabular indices at the ages of three and five years in the residual group were significantly larger than those in the normalized group (both p-values < 0.001). Residual acetabular dysplasia was seen in 84.2% of the residual group compared with 34.8% of the normalized group (p = 0.002). The docking phenomenon can occur during spica casting following GR using traction in children with DDH between the ages of six months and three years. The remaining inverted labrum at the cast removal may negatively affect subsequent acetabular development. III - retrospective comparative study
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