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Developmental dysplasia of the hip in cerebral palsy–surgical treatment

机译:脑瘫的外科手术治疗髋关节发育不良

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摘要

Developmental dysplasia of the hip (DDH) in cerebral palsy (CP) is very rare, and very little clinical data is available. We have analysed the results of open reduction of the hip (Howorth), acetabuloplasty (Salter, Pemberton), pelvic osteotomy (Chiari) and femoral osteotomy in the treatment of the DDH in CP patients. Radiographic assessment was based on the Severin grading classification system and measurements of migration percentage (MP) before and after surgery. Clinical results were analysed using the Ponsetti classification system in ambulatory patients. A total of 45 hips in 31 patients were treated surgically. The average age of the patients was 5.2 years (range: 2–16 years). The average follow-up was 9.6 years (range: 3–28 years). Analysis of the radiographic results according to Severin placed 35 hips (77.8%) in groups 1 and 2 and ten hips (22.2%) in groups 3 and higher. The average preoperative MP value was 78.7% and the average postoperative MP was 15.2%. Redislocation occurred in three hips. Clinical results were disappointing: based on Ponsetti assessment 14 hips (36.8%) were classified in the first three groups and 24 hips (63.2%) in the last three groups. This analysis suggests that these surgical procedures could be applied in treating DDH in CP.
机译:大脑性麻痹(CP)中的髋部发育不良(DDH)非常罕见,并且几乎没有临床数据。我们分析了CP患者DDH的髋部切开复位术(Howorth),髋臼成形术(Salter,Pemberton),骨盆截骨术(Chiari)和股骨截骨术的结果。射线照相评估基于Severin分级分类系统以及术前和术后的迁移百分比(MP)的测量。使用Ponsetti分类系统对门诊患者的临床结果进行了分析。 31例患者共45髋接受了手术治疗。患者的平均年龄为5.2岁(范围:2-16岁)。平均随访9。6年(范围:3 – 28年)。根据Severin进行的放射学结果分析在第1组和第2组中放置35髋(77.8%),在第3组及更高组中放置10髋(22.2%)。术前平均MP值为78.7%,术后平均MP为15.2%。重新分配发生在三个髋部。临床结果令人失望:根据Ponsetti评估,前三组分为14髋(36.8%),后三组为24髋(63.2%)。该分析表明,这些手术方法可用于治疗CP中的DDH。

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