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目的探讨外展支具早期治疗髋关节发育不良(developmental dysplasia of the hip,DDH)的疗效,并分析影响疗效的因素。方法回顾性分析我院2013年10月至2015年6月收治的223例(270髋)髋关节发育不良患儿资料,其中男性53例,女性170例;年龄1~183(62.41±23.82)d,中位年龄58 d;左侧151髋,右侧119髋,单侧142髋,双侧64髋;超声Graf分型:Ⅱa型143髋,Ⅱb型75髋,Ⅱc型11髋,D型13髋,Ⅲ型19髋,Ⅳ型9髋,均采用外展支具治疗,每隔3~4周超声监测髋关节形态变化,>6个月行X线摄片,支具治疗时间3~20周,随访时间12~24个月,平均16.4个月。结果 206例(250髋)经外展支具治疗后恢复正常形态,且无一例发生股骨头坏死;17例(20髋)治疗失败,其中17髋改行石膏固定术治疗,3髋行Salter骨盆截骨手术治疗。结论外展支具是早期治疗髋关节发育不良安全、有效的方法之一,对GrafⅡ型髋关节治愈率高,对Ⅲ型及Ⅳ型治愈率低,但可尝试作为初始治疗的方法;超声检查对于早期诊治髋关节发育不良具有重要意义。
Objective To explore the curative effect of outreach brace for early treatment of dysplasia of the hip (DDH) and to analyze the factors influencing the curative effect. Methods The data of 223 cases (270 hips) with hip dysplasia admitted from October 2013 to June 2015 in our hospital were retrospectively analyzed. There were 53 males and 170 females, ranging in age from 1 to 183 (62.41 ± 23.82) d , With a median age of 58 days. There were 151 hips on the left side, 119 hips on the right side, 142 hips on one side and 64 hips on both sides. The Graf classification was: 143 hips in type IIa, 75 hips in type IIb, 11 hips in type IIc, Hip, type Ⅲ 19 hips, type Ⅳ 9 hips, were used outreach brace treatment, every 3 to 4 weeks ultrasound monitoring of hip joint morphology,> 6 months underwent radiography, brace treatment time 3 to 20 Week, follow-up time of 12 to 24 months, an average of 16.4 months. Results 206 patients (250 hips) returned to their normal form after treatment with outreach brace, and none of them had necrosis of the femoral head. Seventeen patients (20 hips) failed to complete the treatment. Among them, 17 hips were treated by gypsum fixation and 3 hips were performed with Salter pelvic dissection Bone surgery. Conclusion Outreach brace is one of the safe and effective methods for early treatment of dysplasia of hip. It has high cure rate for Graf type II hip and low cure rate for type Ⅲ and Ⅳ, but it may be used as an initial treatment method. Ultrasonography For early diagnosis and treatment of hip dysplasia is of great significance.