Duration of immobilization after developmental dysplasia of the hip and open reduction surgery
Duration of immobilization after developmental dysplasia of the hip and open reduction surgery
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DOI：
10.1007/s00264-018-3962-3
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发表时间：
2019-02-01
影响因子：
2.7
通讯作者：
Hayyawi, Fahad Abdulazeez
中科院分区：
文献类型：
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作者：
Emara, Khaled;Kersh, Mohamed Ahmed A. L.;Hayyawi, Fahad Abdulazeez
背景对于发育性髋关节发育不良（developmental dysplasia of hip，DDH）术后制动时间的长短，目前尚无统一的认识。本研究的目的是比较两种手术后固定方案对接受开放复位的患者的影响。A组32例（8髋）髋关节固定4周后，应用外展支具，术后数月逐渐脱离; B组24例（29髋）髋关节固定12周，不应用外展支具更多的支撑。两组患者均在12- 24个月时采用前路手术复位。结果两组患者的临床和影像学结果无显著性差异，但随访时两组患者的AVN（缺血性坏死）有显著性差异。AVN的发生率与制动方法无关，因为有许多因素可导致髋关节AVN，如极端位置制动和过紧Reduction. ConclusionA组术后制动方案比B组更安全，并发症少，患者和家长更舒适。早期取出髋关节石膏和应用髋关节外展支具不会增加再脱位率。证据等级III级回顾性比较研究
BackgroundThere is no consensus about the duration of post-operative immobilization in the treatment of DDH (developmental dysplasia of hip). Our aim in this study is to compare between two post-operative immobilization protocols for patients undergoing open reduction.Materials and methodsThirty-eight hips in 32 patients assigned to group A were immobilized in hip spica for fourweeks followed by abduction brace application which was gradually weaned through the periods of several months and 29 hips in 24 patients assigned to group B immobilized in hip spica for 12weeks without further bracing. Both groups were surgically reduced using anterior approach between the ages of 12-24months.ResultsThere were non-significant statistical difference between both groups as regards clinical and radiological outcome but there is significant statistical difference as regards AVN (avascular necrosis) on follow-up between both groups. The rate of AVN cannot be related to the method of immobilization, as there are many factors can lead to AVN of the hip as immobilization in an extreme position and tight reduction.ConclusionGroup A post-operative immobilization protocol is safer and associated with less complications and more comfortable to the patient and parents than that used in group B. Early removal of hip spica cast and application of hip abduction brace does not increase the rate of re-dislocation.Level of EvidenceLevel III Retrospective comparative study