外展支具配合学步车与改良蛙式石膏治疗发育性髋关节脱位疗效评价

Effects evaluation of two methods treating developmental dysplasia of the hip

目的评价可调可塑外展支具配合学步车和改良蛙式石膏对小儿发育性髋关节脱位(DDH)的治疗效果。方法随访分析年龄为6～36个月DDH患儿126例(224髋),比较外展支具配合学步车组(70例)与改良蛙式石膏组(56例)的治疗效果及术后并发症的发生率。结果两种方法疗效优良率分别为89.2%和94.7%,差异无显著性。外展支具配合学步车组股骨头坏死的比例显著低于改良蛙式石膏组(分别为3.8%和20.2%),但前者术后发生再脱位的比例显著高于后者(分别为15.4%和2.1%)。结论两种方法均能有效治疗DDH,外展支具配合学步车治疗后出现股骨头坏死比例较低,但再脱位比例较高。

[Objective] To evaluate two methods of treating developmental dysplasia of the hip （DDH）： the abdueens orthosis in cooperative with walker and the improved hip frog east fixation. [Methods] 126 cases （224 hips） of 6 months to 36 months age children with DDH were been fallowed-up and analyzed. 70 eases were treated by the orthosis in cooperative with walker and 56 cases were treated by the improved hip frog cast fixation, then compare the effect and complication of the two methods. [Results] The fineness rates of two treatments were 89.2% aml 94.7% respectively, with no significant difference. The rate of femoral head osteonecrosis in the orthosis in cooperative with walker group was significantly lower than the improved hip frog cast fixation group （3.8% and 20.2%,respectively）, but the re-dislocation rate taken place in former was significantly higher than in the latter （15.4% and 2.1%,respectively）. [Conclusions] Both of the two methods were effective on treating DDH, the orthosis in cooperative with walker treatment had a lower proportion of femoral head osteoneerosis, but also have a higher proportion of re-dislocation.