Developmental Dysplasia of the Hip From Six Months to Four Years of Age
Developmental Dysplasia of the Hip From Six Months to Four Years of Age
复制标题
六个月至四岁的发育性髋关节发育不良
DOI：
10.5435/00124635-200111000-00005
复制
发表时间：
2001
影响因子：
3.2
通讯作者：
D. Skaggs
中科院分区：
文献类型：
--
作者：
M. Vitale;D. Skaggs
发育性髋关节发育不良(DDH)指的是一系列的病理情况，从轻微的髋臼发育不良到不可复性的髋关节脱位。当DDH在生命的前6个月被发现时，使用Pavlik马具治疗往往会产生良好的结果。对于6个月以上的儿童，实现向心性髋关节缩小同时将并发症降至最低更具挑战性。支撑、牵引、闭合复位、切开复位、股骨或骨盆截骨术是6个月至4岁儿童常用的治疗方法。在过去，治疗建议通常是基于患者的年龄。然而，最近的实践更多地强调解决特定的疾病和避免医源性骨坏死。通过避免在极端外展的情况下固定髋关节，并在适当的情况下使用股骨短缩截骨术，股骨头坏死的发生率已经降低。骨盆截骨术在治疗18个月以上的特定患者方面继续受到青睐。
&NA; Developmental dysplasia of the hip (DDH) denotes a wide spectrum of pathologic conditions, ranging from subtle acetabular dysplasia to irreducible hip dislocation. When DDH is recognized in the first 6 months of life, treatment with a Pavlik harness frequently results in an excellent outcome. In children older than 6 months, achieving a concentrically reduced hip while minimizing complications is more challenging. Bracing, traction, closed reduction, open reduction, and femoral or pelvic osteotomies are frequently used treatment modalities for children aged 6 months to 4 years. In the past, treatment recommendations have often been based on the patient’s age. However, recent practice has placed more emphasis on addressing the specific disorder and avoiding iatrogenic osteonecrosis. The incidence of osteonecrosis of the femoral head has been reduced by avoiding immobilization of the hip in extreme abduction and by using femur‐shortening osteotomies when appropriate. Pelvic osteotomy continues to gain favor for the treatment of selected patients over 18 months of age.