265例发育性髋关节脱位治疗分析

Analysis the Results of Non-operative Treatment for 265 Patients with Developmental Dislocation of Hip(DDH)

目的探讨非手术治疗265例发育性髋关节脱位患儿的疗效。方法 1995年至2011年共收治265例（共312髋）发育性髋关节脱位,其中男41例,女224例,年龄4个月~3.5岁,平均1.4岁。左侧128例,右侧90例,双侧47例。按脱位程度分型,Ⅰ型41髋,Ⅱ型102髋,Ⅲ型169髋。根据年龄分为四组,一组：1岁以内81例,二组：1~2岁117例,三组：2~3岁46例,四组：大于3岁21例。采用牵引、内收肌松解、手法复位、四期树脂绷带外固定治疗。采用Mckaym临床标准和Severi X线标准进行疗效评估。结果经随访1.5年后疗效评价：Mckaym临床评分总优良率85.57%,Severi X线评分总优良率82.37%。结论手法复位加树脂绷带外固定是治疗发育性髋关节脱位早期（小于3岁）最有效的方法,应尽早治疗。

Objective To study the clinical results of non-operative treatment for 265patients with developmental dislocation of hip（DDH）.Methods From March 1995to November 2011,265patients（312hips）with DDH were treated by non-operative methods.There were 41males and 224female patient aged 4months to 5years（averge 1.4 years）,in which 81patients were less than 1years old,117patients were from 1to 2years old,46patients were from 2 to 3years old and 21patients were more than 3years old.128cases had DDH on the left and 90on the right side.47cases were bilateral.According to the severity of the dislocation type（Hartofilakidis）,there were 41typeⅠ,102typeⅡ and 169typeⅢ.All the patients were treated by traction,adductor muscle lysis,manipulative reduction and four stage resin bandage fixation.The patients were analysised by Mckaym clinical standards and Severi X ray standards.Results After1.5years treatment,8 5.5 7% patients were excellent or good according to Mckaym total clinical score and 82.37% patients were excellent or good according to Severi radiographic scoring.Conclusion Manipulative reduction and four stage resin bandage external fixation were effective method for the patients of early DDH（3years）.The patients should be treated as soon as possible.