Residual acetabular dysplasia after Pavlik harness treatment for Graf type II hips.

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Childrens Orthopaedics Pub Date : 2023-08-01 DOI:10.1177/18632521231182423
Yuchan Li, Zhigang Wang, Mingyuan Miao, Yunlan Xu, Jing Shi
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Abstract

Purpose: To evaluate the residual acetabular dysplasia in Graf type II hips after Pavlik harness treatment with a radiographic follow-up at 2 years of age.

Methods: We retrospectively reviewed the developmental dysplasia of the hip patients who were treated with the Pavlik harness between March 2018 and February 2022. Patients with Graf type II hip dysplasia who had at least one radiographic follow-up after 2 years of age were included. The following information, sex, laterality, affected side, age at harness initiation, treatment duration, α angle, and the morphology of bony roof, was collected and studied. We evaluated the radiographic acetabular index at the last follow-up and defined the value of greater than 2 standard deviations as residual acetabular dysplasia.

Results: A total of 33 patients (53 hips) met the criteria. The mean initial α angle was 53.4°; the mean age at Pavlik harness initiation was 10.9 weeks. The mean treatment duration was 10 weeks. The mean α angle at the last ultrasound follow-up was 64.9°. The mean age of the last radiographic follow-up was 2.6 years, and 26 hips had a residual acetabular dysplasia with acetabular indexes greater than 2 standard deviations above the mean. The morphology of the acetabular bony rim (odds ratio = 4.333, P = 0.029) and age of initial treatment <12 weeks (odds ratio = 7.113, P = 0.014) were seen as significant predictors for a higher acetabular index more than 2 years of age.

Conclusions: A notable incidence of residual acetabular dysplasia after Pavlik harness treatment in Graf type II hips, wherein the acetabular bony roof with a blunt rim at the end of treatment and initial age after 12 weeks were independent predictors associated with residual acetabular dysplasia.

Levels of evidence: Therapeutic studies, IV.

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Graf II型髋关节Pavlik支架治疗后残留的髋臼发育不良。
目的:评价Graf II型髋关节在Pavlik支架治疗后残留的髋臼发育不良,并在2岁时进行影像学随访。方法:回顾性分析2018年3月至2022年2月期间使用Pavlik托具治疗的髋关节发育不良患者。Graf II型髋关节发育不良患者在2岁后至少进行了一次影像学随访。收集和研究了以下信息:性别、侧位、患侧、脊具起始年龄、治疗时间、α角和骨顶形态。我们在最后一次随访时评估髋臼指数,并将大于2个标准差的值定义为残余髋臼发育不良。结果:33例患者(53髋)符合标准。平均初始α角为53.4°;Pavlik马具开始时的平均年龄为10.9周。平均治疗时间为10周。末次超声随访时平均α角为64.9°。最后一次x线随访的平均年龄为2.6岁,26髋髋臼发育不良,髋臼指数高于平均值2个标准差以上。结论:在Graf II型髋中,Pavlik支架治疗后残留髋臼发育不良的发生率显著,其中治疗结束时髋臼骨顶钝缘和12周后的初始年龄是残留髋臼发育不良的独立预测因素。证据水平:治疗性研究,IV。
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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
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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