Management of hip dislocation with postural management
Management of hip dislocation with postural management
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DOI：
10.1046/j.1365-2214.2002.00254.x
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发表时间：
2002-03-01
影响因子：
1.9
通讯作者：
Gard, P
中科院分区：
文献类型：
--
作者：
Pountney, T;Mandy, A;Gard, P
背景脑瘫儿童髋关节脱位已有充分记录的病史和发病率。目的本文对双侧脑瘫儿童进行不同姿势治疗及其对髋关节畸形的影响进行回顾性研究。最广泛接受的髋部半脱位/脱位理论模型是髋部周围肌肉长度和力量的不平衡导致髋臼发育不良并随之而来的髋部半脱位。因此，维持肌肉长度、力量和承重是合理的预防措施。对正常婴儿姿势的研究为24小时姿势管理设备提供了生物力学数据的理论基础。方法对来自东萨塞克斯郡、西萨塞克斯郡和牛津郡的59名双侧脑瘫儿童进行笔记和X线检查和测量，以确定姿势管理与髋关节半脱位/脱位程度之间是否存在关系。 X 射线使用 Reimers 髋关节迁移百分比进行测量。姿势管理支持分为三组进行分析。第 1 类：使用 Chailey 可调节姿势支撑 (CAPS) 系统在躺着、坐着和站立时使用 24 小时姿势管理方法；类别 2：两项 CAPS（躺着/坐着或坐着/站立支撑）；类别 3：仅使用 CAPS 座椅和/或任何其他姿势支撑。记录髋部状态用于分析，双侧髋部安全（移位率低于 33%），或一侧/双侧髋部半脱位。结果 在髋部半脱位前使用“All CAPS”的儿童比其他组保持了显着更高的髋部完整性（chi(2) P < 0.05）。结论 姿势管理干预措施在预防髋关节发育不良方面具有重要作用。
Background Hip dislocation in children with cerebral palsy has a well-documented history and morbidity.Objective This paper presents a retrospective study of children with bilateral cerebral palsy who had various postural management and its effect on hip deformity. The most widely accepted theoretical model of hip subluxation/dislocation is that an imbalance in muscle length and strength around the hip leads to acetabular dysplasia and consequent hip subluxation. Maintenance of muscle length and strength and loadbearing is therefore a logical prevention. Research on normal infants' postures has provided biomechanical data to form the theoretical basis of 24 h postural management equipment.Methods The notes and X-rays of 59 children with bilateral cerebral palsy from East and West Sussex and Oxfordshire were examined and measured to determine whether a relationship existed between postural management and the level of hip subluxation/dislocation. X-rays were measured using Reimers' hip migration percentage. Postural management support was divided into three groups for analysis. Category 1: use of a 24-h postural management approach using Chailey Adjustable Postural Support (CAPS) systems in lying, sitting and standing; category 2: two items of CAPS (either lying/sitting or sitting/standing supports); category 3: use of the CAPS seat only and/or any other postural supports. Hip status was recorded for analysis as both hips safe (under 33% migrated), or one/both hips subluxed.Results Children using 'All CAPS' before hip subluxation maintained significantly more hip integrity than other groups (chi(2) P < 0.05).Conclusions Postural management interventions have an important role in the prevention of hip dysplasia.