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[目的]观察探讨应用矫形器对婴幼儿发育性髋关节脱位的治疗效果。[方法]对92例155髋2岁以内婴幼儿,根据年龄、髋臼发育程度及头臼位置关系选用不同型号矫形器治疗,定期复查髋关节X线片,记录髋臼指数(AI)变化及头臼位置关系,作为疗效评定依据。[结果]随访6～52个月,平均28个月。92例155髋复位成功率:年龄≤6个月组91.01%,7～12个月组76.19%,>12个月组54.16%;Ⅰ度脱位成功率83.87%,Ⅱ度脱位为84.48%,Ⅲ度脱位为54.55%,半脱位为79.16%。治疗前AI均值:成功髋30.44°±6.48°,失败髋37.58°±5.28°。无股骨头坏死病例出现。[结论]矫形器对婴幼儿发育性髋脱位有显著治疗作用,疗效与患儿初始治疗年龄、髋臼发育程度及矫形器治疗时间有密切关系。正确的矫形器佩戴方法及治疗时间直接影响髋关节复位的远期效果。
[Objective] To investigate the therapeutic effect of orthosis on developmental dislocation of infants and young children. [Methods] Ninety - two infants and young children with 155 hips within 2 years of age were enrolled in this study. According to the age, the development of acetabulum and the position of acetabulum, different models of orthosis were selected. Hip X - ray films were regularly reviewed and changes of acetabular index (AI) Head mortar position, as the basis for evaluation of efficacy. [Result] The patients were followed up for 6 ~ 52 months with an average of 28 months. In 92 cases, the successful rate of 155 hips reduction was 91.01% in the group of ≤6 months, 76.19% in the group of 7-12 months and 54.16% in the group of> 12 months. The successful rate of dislocation in grade Ⅰ was 83.87%, the degree of dislocation in grade Ⅱ was 84.48% Degree of dislocation was 54.55%, subluxation was 79.16%. Mean AI before treatment: successful hip 30.44 ° ± 6.48 °, failed hip 37.58 ° ± 5.28 °. No cases of femoral head necrosis. [Conclusion] The orthosis has a significant therapeutic effect on the developmental dislocation of the hip in infants. The curative effect is closely related to the initial treatment age, the degree of acetabular development and the duration of orthosis. The right orthosis wear method and treatment time directly affect the long-term effect of hip replacement.