在帕夫利克背带治疗发育不良的髋关节期间,股神经麻痹不是放弃背带的指征。

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Childrens Orthopaedics Pub Date : 2023-06-01 DOI:10.1177/18632521231172986
Ismat Ghanem, Geoffrey Karam, Diane Ghanem, Ibrahim Saliba
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引用次数: 0

摘要

目的:本研究的目的是报道使用Pavlik背带治疗的发育性发育不良儿童股骨神经麻痹的发生率,确定任何可能的相关危险因素,并评估其结果,而无需任何特定的背带松解。方法:对连续接受帕夫利克托具治疗髋关节发育不良的所有儿童股骨神经麻痹病例进行回顾性分析。在单侧病例中,将髋关节发育不良与对侧进行比较。所有股骨神经麻痹的髋关节与该系列的其余髋关节进行比较,并记录任何可能导致瘫痪的危险因素。结果:在473例527髋的儿童中,共鉴定出53例不同程度的股神经麻痹,平均年龄为3.9个月。然而,93%发生在治疗的前2周。股骨神经麻痹多见于年龄较大、体型较大的儿童,且最严重的Tonnis型患儿,髋部屈曲角度大于90°(p)结论:股骨神经麻痹多见于较高的Tonnis型患儿和较高的髋部屈曲角度患儿,但其本身的存在并不能预示治疗失败。它在治疗完成前自行解决,不需要任何皮带释放或线束中止。证据等级:三级。
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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Femoral nerve palsy during Pavlik harness treatment for developmental dysplasia of the hip is not an indication for harness abandonment.

Objectives: The aim of this study was to report the incidence of femoral nerve palsy in developmental dysplasia of the hip children treated with Pavlik harness, to identify any possible associated risk factors, and to evaluate its outcome without any specific strap release.

Methods: A retrospective chart review was conducted on all cases of femoral nerve palsy in a consecutive series of children who underwent Pavlik harness treatment for developmental dysplasia of the hip. In unilateral cases, the developmental dysplasia of the hip was compared to the contralateral side. All hips with femoral nerve palsy were compared to the remaining hips of the series and any possible risk factor for paralysis was recorded.

Results: In total, 53 cases of femoral nerve palsy of various severity were identified from a group of 473 children with 527 hips treated for developmental dysplasia of the hip at an average age of 3.9 months. However, 93% occurred during the first 2 weeks of treatment. Femoral nerve palsy was more common in older and larger children with the most severe Tonnis type, and a hip flexion angle in the harness above 90° (p < 0.03 for all). All of them resolved spontaneously before completion of treatment without any specific measures. We found no correlation between the presence of femoral nerve palsy or the time taken for spontaneous resolution and treatment failure using the harness.

Conclusion: Femoral nerve palsy is most observed with higher Tonnis types and high hip flexion angles in the harness, but its presence by itself is not predictive of treatment failure. It resolves spontaneously before completion of treatment and does not require any strap release or harness discontinuation.

Level of evidence: Level III.

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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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