目的 研究先天性膝关节脱位的治疗方法,对石膏矫形治疗的可行性及指征进行探讨.方法 对2006～2009年就诊的患者采用系列石膏矫形的方法进行复位治疗,共8例11膝,年龄1～25个月,其中完全脱位10例,半脱位1例,合并畸形6例.1～2周更换1次石膏,逐渐增加膝关节屈曲度,达到复位者以支具维持至膝关节稳定.结果 经平均5次石膏矫形后,成功复位9膝,失败2膝.失败者就诊时年龄为20个月,合并多发关节挛缩症,且患儿对石膏耐受性差.结论 对2岁以下患者,可试行采用系列石膏结合支具固定的方式来恢复关节对位,可有效减少手术带来的创伤打击;而对于4个月以内的患儿,无论是否合并畸形,均应尝试保守治疗.%Objective To study the treatment method of congenital dislocation of the knee joint and to research how to use the plaster cast to deal with this disease. Methods Eight patients eleven knee joints were treated by series cast in outpatient from 2006 to 2009 in our hospital. All of them had the complete data and gained the follow-up. The patients' ages were from 1 month to 25 months. There were 10 dislocation and 1 subluxation among all the cases. Six cases had combined deformities. To increase the inflexion degrees and get reduction of the knee joints, the patients had been changed the casts every 1 to 2 weeks. After successful reduction long leg harness would be used to keep the position and follow-up would be done. Results There were 9 successful knee joints and 2 failure knee joints after average 5 casts. The failure case was 20month old boy, his tolerance about cast was poor, and there was arthrogryposis combined with him. Conclusions Series casts and harness could be used when the patients below 2 years old to get the reduction and reduce the injury of the operation. Whether with combined deformity the conservative treatment must be tried when the child is less than 4 months.
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