临床小儿外科杂志2024，Vol.23Issue(6)：527-534,8.DOI:10.3760/cma.j.cn101785-202405072-005
发育性髋关节脱位闭合复位后残余髋臼发育不良骨盆截骨时机与指征的多中心前瞻性非随机对照试验研究方案
A multicenter prospective non-randomized controlled protocol on timing and indications of pelvic osteoto-my for residual acetabular dysplasia after closed reduction of developmental dislocation of the hip
摘要
Abstract
Closed reduction under general anesthesia and plaster fixation in human position are com-monly applied for treating developmental dislocation of the hip(DDH)under an age of 24 months.However,a-round one-third of patients still experience residual acetabular dysplasia after closed reduction.Although pelvic osteotomy is widely utilized for residual acetabular dysplasia,its accurate surgical timing and indications have remained elusive.This study was designed to explore timing and indications of surgical intervention for residual acetabular dysplasia after closed reduction of DDH through a multicenter,prospective and non-randomized con-trolled trial.There were 183 children in observation group and 100 in pelvic surgical intervention group.The surgical group underwent Salter and Pemberton,Triple pelvic or Periacetabular osteotomy based upon age.The follow-up period was at least 10 years.Anteroposterior radiographs of hip joint were taken at 8 timepoints of 1/2/3/4/5-6/7-8/9-10/＞10 years post-reduction surgery for measuring the values of acetabular index(AI),center-edge angle of wiberg(CEA)and Reimer's index(RI).According to the Severin grading of the last follow-up,they were assigned into two groups of satisfactory(grade Ⅰ/Ⅱ)and unsatisfactory(grade Ⅲ/Ⅳ).Logistic and COX regressions were employed for examining the risk factors for residual acetabular dysplasi-a and comparing the clinical values of AI,CEA,RI and Severin grades between two groups.This study provided evidence-based medical evidence for timing and indications of surgical interventions for residual acetabular dys-plasia after closed reduction of DDH.关键词
发育性髋关节发育不良/髋脱位,先天性/闭合复位/残余髋臼发育不良/截骨术,骨盆/临床方案/多中心研究Key words
Developmental Dysplasia of the Hip/Hip Dislocation,Congenital/Closed Reduction/Re-sidual Acetabulalr Dysplasia/Osteotomy,Pelvis/Clinical Protocols/Multicenter Studies as Topic引用本文复制引用
李敬春,邵景范,陈顺有,蒋飞,李进,徐宏文,中国儿童骨科多中心研究协作组,刘雁寒,黎艺强,朱光辉,郭跃明,李明,康晓鹏,唐盛平,沈先涛..发育性髋关节脱位闭合复位后残余髋臼发育不良骨盆截骨时机与指征的多中心前瞻性非随机对照试验研究方案[J].临床小儿外科杂志,2024,23(6):527-534,8.基金项目
广州医科大学广州市妇女儿童医疗中心医学系统生物学实验室临床研究基金(GWC-MC2020-6-005) Clinical Research Fund for Medical Systems Biology Laboratory of Guangzhou Women &Children's Medical Center,Guangzhou Medical University(GWCMC2020-6-005) （GWC-MC2020-6-005）
