目的研究髋臼指数(AI),在先天性髋关节脱位(CDH)闭合复位期间的变化规律和影响 AI 变化的因素。方法 24例 CDH 患者(48个髋关节)按治疗前年龄分为3组:大年龄组(>18月,17例),小年龄组(≤18月,21例),正常组(10例),整个过程中设7个时间点摄取 X 线片,测量系列 AI 进行统计分析。结果治疗前,AI:大年龄组>小年龄组>正常组;治疗中,3组 AI 均有下降,下降幅度:小年龄组>大年龄组>正常组:下降速度:小年龄组>大年龄组>正常组。治疗终末,小年龄组已恢复至正常范围,大年龄组仍大于正常范围。结论CDH 治疗前年龄和 AI 值是决定髋臼发育能否恢复正常的两大主要因素。
AIM:To introduce the importance of foot abductor splint on conservative treatment of congenital talipes equinovarus. METHODS:A total of 48 patients with congenital talipes equinovarus(60 feet)(5 days -6 months) in the Department of Orthopaedics,Shanghai Children’s Medical Center,from January 2000 to May 2003,were given conservative treatment.Successive plaster reshaping and subcutaneous achillotenotomy was performed with Posenti method.All patients wore foot abductor splint with the course of 2 years.The first 3 months was full time wearing and the others only sleeping time wearing. RESULTS:All cases were followed up(with the mean follow up period of 14.68 months).Results were satisfactory from the evaluation of X ray and clinical situation. Dimglio score type:46 cases were Type Ⅰ,and 2 cases were TypeⅡa.The age when the manipulation and cast started,the maximum dorsiflexion of the ankle when the splint was started,and the period of the full time wearing in the changes of data in X ray imaging were not related to each other.However,the age when the splint was started was significantly associated with the maximum dorsiflexion of the ankle and the tibio calcaneal angle.CONCLUSION:The foot abductor splint is an indispensably important part for conservative treatment of congenital talipes euinovarus,and is effective to prevent the relapse and maintain good clinical results.
