Follow-up after successful treatment for developmental dysplasia of the hip using a Pavlik harness : is two years enough?

IF 4.9 1区 医学 Q1 ORTHOPEDICS
Jessica P J Larwood, Opeyemi Idowu, Kirsten G B Elliott, Edward A Lindisfarne, Alexander Aarvold
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Abstract

Aims: The length of time for which children, who are treated successfully for developmental dysplasia of the hip (DDH) in a Pavlik harness should be followed up, remains uncertain. The aim of this study was to examine whether children who are treated in this way, who have normal clinical and radiological findings at the age of two years, can be safely discharged from routine follow-up.

Methods: Data were collected prospectively on all 101 children (170 hips) who were treated in a Pavlik harness in our children's hospital between January 2015 and June 2016, with follow-up to the age of five years. Demographic, clinical, and radiological parameters were recorded. Routine anteroposterior radiographs of both hips were taken at the age of one, two and five years. A normal radiograph of the hip was defined as one with an acetabular index (AI) within the normal range when adjusted for age, symmetrical and adequately sized ossific nuclei, an International Hip Dysplasia Institute grade of 1 and a centre-edge angle (CEA) of > 20°.

Results: Of the 101 children (170 hips) who were successfully treated in this way and had radiographs available for analysis from the three timepoints, 157 hips (92%) were normal radiologically at the age of two years and all were normal radiologically at the age of five years. Every child who had normal radiographs at the age of two years had normal clinical and radiological findings at five years, with none having any intervention.

Conclusion: These findings support the suggestion that, following successful treatment with a Pavlik harness, children with DDH can be safely discharged from the clinic, assuming that they are clinically and radiologically normal, at the age of two years instead of five.

使用Pavlik背带成功治疗发育性髋关节发育不良后的随访:2年足够吗?
目的:在帕夫利克套具中成功治疗发育性髋关节发育不良(DDH)的儿童,随访时间的长短仍不确定。本研究的目的是检查接受这种治疗的儿童,在两岁时临床和放射学表现正常,是否可以安全地出院。方法:前瞻性收集2015年1月至2016年6月在我院儿童医院接受Pavlik套治疗的101名儿童(170髋)的数据,随访至5岁。记录人口统计学、临床和放射学参数。分别在1岁、2岁和5岁时拍摄双髋常规正位x线片。正常髋关节x线片定义为:经年龄调整后,髋臼指数(AI)在正常范围内,骨性核对称且大小适当,国际髋关节发育不良研究所分级为1,中心边缘角(CEA)为bbb20°。结果:101名儿童(170髋)通过这种方法成功治疗,并有三个时间点的x线片可供分析,157髋(92%)在2岁时放射学正常,所有5岁时放射学正常。在没有任何干预的情况下,每一个两岁时x光片正常的孩子在五岁时的临床和放射检查结果也正常。结论:这些发现支持这样的建议,即在Pavlik挽具成功治疗后,DDH患儿可以安全地出院,假设他们在临床和放射学上是正常的,在两岁而不是五岁。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Bone & Joint Journal
Bone & Joint Journal ORTHOPEDICS-SURGERY
CiteScore
9.40
自引率
10.90%
发文量
318
期刊介绍: We welcome original articles from any part of the world. The papers are assessed by members of the Editorial Board and our international panel of expert reviewers, then either accepted for publication or rejected by the Editor. We receive over 2000 submissions each year and accept about 250 for publication, many after revisions recommended by the reviewers, editors or statistical advisers. A decision usually takes between six and eight weeks. Each paper is assessed by two reviewers with a special interest in the subject covered by the paper, and also by members of the editorial team. Controversial papers will be discussed at a full meeting of the Editorial Board. Publication is between four and six months after acceptance.
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