Lian Duan, Federico Canavese, Weizheng Zhou, Yufan Chen, Lianyong Li
{"title":"Petit-Morel 与高架牵引法与立即闭合复位法治疗晚期发现的髋关节发育不良的长期疗效比较：系统综述。","authors":"Lian Duan, Federico Canavese, Weizheng Zhou, Yufan Chen, Lianyong Li","doi":"10.1177/18632521241265603","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the clinical and radiographic outcomes of traction to assist reduction in patients with late-detected developmental dislocation of the hip using the Petit-Morel technique versus the Bryant overhead traction technique, and to compare the clinical and radiographic outcomes of these two traction techniques with immediate closed reduction.</p><p><strong>Methods: </strong>A comprehensive systematic search of the MEDLINE/PubMed, EMBASE, and Web of Science databases was performed to identify relevant studies. Studies on Petit-Morel and overhead traction techniques and immediate closed reduction were then screened, selected, and data collected; included studies were assessed using the Methodological Index for Non-Randomized Studies criteria.</p><p><strong>Results: </strong>In total, 22 studies met the inclusion criteria. The Petit-Morel group had a successful reduction rate of 87% while the overhead traction group had a successful reduction rate of 67.1%, and the immediate closed reduction group had a successful reduction rate of 78.4% (Petit-Morel versus overhead traction, p < 0.001; overhead traction versus immediate closed reduction, p < 0.001, Petit-Morel versus immediate closed reduction, p = 0.021). The Petit-Morel group had an overall avascular necrosis rate of 2.7%, compared to 10.6% for overhead traction and 21.5% for immediate closed reduction (Petit-Morel versus overhead traction, p = 0.001; Petit-Morel versus immediate closed reduction, p < 0.001; overhead traction versus immediate closed reduction, p < 0.001). The Petit-Morel group achieved a satisfaction rate of 86.4% according to the Severin classification, as compared to 71.2% in the overhead traction group and 76.4% in the immediate closed reduction group (Petit-Morel versus overhead traction, p < 0.001; Petit-Morel versus immediate closed reduction, p = 0.018; overhead traction versus immediate closed reduction, p = 0.195).</p><p><strong>Conclusion: </strong>Petit-Morel and overhead traction techniques did not outperform immediate closed reduction in terms of redislocation rates, and radiological satisfaction, the Petit-Morel technique, has lower clinically significant avascular necrosis rates than overhead traction and immediate closed reduction.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"18632521241265603"},"PeriodicalIF":1.3000,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569515/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparative long-term outcomes of Petit-Morel versus overhead traction methods versus immediate closed reduction for late-detected developmental dysplasia of the hip: A systematic review.\",\"authors\":\"Lian Duan, Federico Canavese, Weizheng Zhou, Yufan Chen, Lianyong Li\",\"doi\":\"10.1177/18632521241265603\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study aimed to compare the clinical and radiographic outcomes of traction to assist reduction in patients with late-detected developmental dislocation of the hip using the Petit-Morel technique versus the Bryant overhead traction technique, and to compare the clinical and radiographic outcomes of these two traction techniques with immediate closed reduction.</p><p><strong>Methods: </strong>A comprehensive systematic search of the MEDLINE/PubMed, EMBASE, and Web of Science databases was performed to identify relevant studies. Studies on Petit-Morel and overhead traction techniques and immediate closed reduction were then screened, selected, and data collected; included studies were assessed using the Methodological Index for Non-Randomized Studies criteria.</p><p><strong>Results: </strong>In total, 22 studies met the inclusion criteria. The Petit-Morel group had a successful reduction rate of 87% while the overhead traction group had a successful reduction rate of 67.1%, and the immediate closed reduction group had a successful reduction rate of 78.4% (Petit-Morel versus overhead traction, p < 0.001; overhead traction versus immediate closed reduction, p < 0.001, Petit-Morel versus immediate closed reduction, p = 0.021). The Petit-Morel group had an overall avascular necrosis rate of 2.7%, compared to 10.6% for overhead traction and 21.5% for immediate closed reduction (Petit-Morel versus overhead traction, p = 0.001; Petit-Morel versus immediate closed reduction, p < 0.001; overhead traction versus immediate closed reduction, p < 0.001). The Petit-Morel group achieved a satisfaction rate of 86.4% according to the Severin classification, as compared to 71.2% in the overhead traction group and 76.4% in the immediate closed reduction group (Petit-Morel versus overhead traction, p < 0.001; Petit-Morel versus immediate closed reduction, p = 0.018; overhead traction versus immediate closed reduction, p = 0.195).</p><p><strong>Conclusion: </strong>Petit-Morel and overhead traction techniques did not outperform immediate closed reduction in terms of redislocation rates, and radiological satisfaction, the Petit-Morel technique, has lower clinically significant avascular necrosis rates than overhead traction and immediate closed reduction.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":56060,\"journal\":{\"name\":\"Journal of Childrens Orthopaedics\",\"volume\":\" \",\"pages\":\"18632521241265603\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-11-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569515/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Childrens Orthopaedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/18632521241265603\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Childrens Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/18632521241265603","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究旨在比较采用 Petit-Morel 技术和 Bryant 头顶牵引技术对晚期发现的发育性髋关节脱位患者进行牵引辅助复位的临床和影像学效果，并比较这两种牵引技术与立即闭合复位的临床和影像学效果：方法：对 MEDLINE/PubMed、EMBASE 和 Web of Science 数据库进行了全面系统的检索，以确定相关研究。然后对有关 Petit-Morel 和高架牵引技术及即刻闭合复位术的研究进行筛选、选择并收集数据；采用非随机研究方法索引标准对纳入的研究进行评估：共有 22 项研究符合纳入标准。Petit-Morel 组的成功缩复率为 87%，而高位牵引组的成功缩复率为 67.1%，即刻闭合缩复术组的成功缩复率为 78.4%（Petit-Morel 与高位牵引相比，P在再脱位率和放射学满意度方面，Petit-Morel和高架牵引技术并不比即刻闭合复位术更胜一筹，Petit-Morel技术的临床显著性血管坏死率低于高架牵引和即刻闭合复位术：证据等级：三级。
Comparative long-term outcomes of Petit-Morel versus overhead traction methods versus immediate closed reduction for late-detected developmental dysplasia of the hip: A systematic review.
Purpose: This study aimed to compare the clinical and radiographic outcomes of traction to assist reduction in patients with late-detected developmental dislocation of the hip using the Petit-Morel technique versus the Bryant overhead traction technique, and to compare the clinical and radiographic outcomes of these two traction techniques with immediate closed reduction.
Methods: A comprehensive systematic search of the MEDLINE/PubMed, EMBASE, and Web of Science databases was performed to identify relevant studies. Studies on Petit-Morel and overhead traction techniques and immediate closed reduction were then screened, selected, and data collected; included studies were assessed using the Methodological Index for Non-Randomized Studies criteria.
Results: In total, 22 studies met the inclusion criteria. The Petit-Morel group had a successful reduction rate of 87% while the overhead traction group had a successful reduction rate of 67.1%, and the immediate closed reduction group had a successful reduction rate of 78.4% (Petit-Morel versus overhead traction, p < 0.001; overhead traction versus immediate closed reduction, p < 0.001, Petit-Morel versus immediate closed reduction, p = 0.021). The Petit-Morel group had an overall avascular necrosis rate of 2.7%, compared to 10.6% for overhead traction and 21.5% for immediate closed reduction (Petit-Morel versus overhead traction, p = 0.001; Petit-Morel versus immediate closed reduction, p < 0.001; overhead traction versus immediate closed reduction, p < 0.001). The Petit-Morel group achieved a satisfaction rate of 86.4% according to the Severin classification, as compared to 71.2% in the overhead traction group and 76.4% in the immediate closed reduction group (Petit-Morel versus overhead traction, p < 0.001; Petit-Morel versus immediate closed reduction, p = 0.018; overhead traction versus immediate closed reduction, p = 0.195).
Conclusion: Petit-Morel and overhead traction techniques did not outperform immediate closed reduction in terms of redislocation rates, and radiological satisfaction, the Petit-Morel technique, has lower clinically significant avascular necrosis rates than overhead traction and immediate closed reduction.
期刊介绍：
Aims & Scope
The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery.
It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents.
The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology.
The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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