外展支具配合学步车治疗发育性髋关节脱位的疗效评价

Effect of abducens orthosis combined with walker on developmental dysplasia of the hip

目的:评价可调可塑外展支具配合学步车对小儿发育性髋关节脱位(developmental dysplasia of the hip,DDH)的治疗效果。方法:收集湘雅医院126例(224髋)6～36月的DDH患儿,随机分为支具加学步车组70例(130髋)与改良蛙式石膏组56例(94髋),比较2组的治疗效果及术后并发症的发生率。结果:支具加学步车组与改良蛙式石膏组疗效优良率分别为89.2%和90.4%,差异无统计学意义(P>0.05)。支具加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1.5%和5.3%,P<0.05),但前者术后发生再脱位的比例显著高于后者(分别为6.9%和1.1%,P<0.05)。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 the effect of abducens orthosis combined with walker on developmental dysplasia of the hip （ DDH ）. Methods A total of 126 patients （ 224 hips ） with DDH aged 6 -36 months in Xiangya Hospital was randomly divided into 2 groups： an orthosis combined with walker group and an improved hip frog cast fixation group. Seventy patients （130 hips ）were treated by the orthosis combined with walker and 56 patients （94 hips ） were treated by the improved hip frog cast fixation. We compared the effect and complications of the 2 groups. Results The fineness rates of the orthosis combined with walker group and the improved hip frog cast fixation group were 89.2% and 90.4% , respectively, with no significant difference （ P 〉 0.05 ）. The rate of femoral head osteonecrosis in the orthosis combined with walker group was significantly lower than that in the improved hip frog cast fixation group （1.5% vs. 5.3% , P 〈 0.05 ） , but the re-islocation rate in the former was significantly higher than that in the latter （ 6.9 % vs. 1. 1% , P 〈 0.05 ）. Conclusion Both methods are effective for DDH. Orthosis combined with walker has a lower proportion of femoral head osteonecrosis, but a higher proportion of re-dislocation.