Traction does not decrease failure of reduction and femoral head avascular necrosis in patients aged 6-24 months with developmental dysplasia of the hip treated by closed reduction: a review of 385 patients and meta-analysis

被引：23

作者：

Li, Yi-Qiang ^{[1
]}

Li, Ming ^{[2
]}

Guo, Yue-Ming ^{[3
]}

Shen, Xian-Tao ^{[4
]}

Mei, Hai-Bo ^{[6
]}

Chen, Shun-You ^{[7
]}

Shao, Jing-Fan ^{[5
]}

Tang, Sheng-Ping ^{[8
]}

Canavese, Federico ^{[1
]}

Xu, Hong-Wen ^{[1
]}

机构：

[1] Guangzhou Med Univ, Dept Pediat Orthopaed, Guangzhou Women & Childrens Med Ctr, Guangzhou, Guangdong, Peoples R China

[2] Chongqing Med Univ, Childrens Hosp, Chongqing, Peoples R China

[3] Foshan Hosp TCM, Foshan, Peoples R China

[4] Wuhan Women & Children Med Care Ctr, Wuhan, Hubei, Peoples R China

[5] Huazhong Univ Sci & Technol, TongJi Med Coll, TongJi Hosp, Wuhan, Hubei, Peoples R China

[6] Hunan Childrens Hosp, Changsha, Hunan, Peoples R China

[7] Fuzhou Second Hosp, Fuzhou, Fujian, Peoples R China

[8] Shenzhen Childrens Hosp, Shenzhen, Peoples R China

来源：

JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B | 2019年 / 28卷 / 05期

关键词：

avascular necrosis of the femoral head; closed reduction; developmental dysplasia of the hip; failure of reduction; meta-analysis; traction; CONGENITAL DISLOCATION; RISK-FACTORS; MANAGEMENT; CHILDREN; PREDICTOR;

D O I：

10.1097/BPB.0000000000000586

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

This study aimed to investigate the effects of preliminary traction on the rate of failure of reduction and the incidence of femoral head avascular necrosis (AVN) in patients with late-detected developmental dysplasia of the hip treated by closed reduction. A total of 385 patients (440 hips) treated by closed reduction satisfied the inclusion criteria. Patients were divided in two groups according to treatment modality: a traction group (276 patients) and a no-traction group (109 patients). Tonnis grade, rate of failure reduction, AVN rate, acetabular index, center-edge angle of Wiberg, and Severin's radiographic grade were assessed on plain radiographs, and the results were compared between the two groups of patients. In addition, a meta-analysis was performed based on the existing comparative studies to further evaluate the effect of traction on the incidence of AVN. Tonnis grade in the traction group was significantly higher than in the no-traction group (P = 0.021). The overall rate of failure reduction was 8.2%; no significant difference was found between the traction (9.2%) and no-traction groups (5.6%) (P = 0.203). The rates of failure reduction were similar in all Tonnis grades, regardless of treatment modality (P > 0.05). The rate of AVN in the traction group (14%) was similar to that of the no-traction group (14.5%; P = 0.881). Moreover, the rates of AVN were similar in all Tonnis grades, regardless of treatment modality (P > 0.05). The meta-analysis did not identify any significant difference in the AVN rate whether preliminary traction was used or not (odds ratio = 0.76, P = 0.32). At the last follow-up visit, the two groups of patients had comparable acetabular indices, center-edge angles, and Severin's radiographic grades (P > 0.05). In conclusion, preliminary traction does not decrease the failure of reduction and the incidence of AVN in developmental dysplasia of the hip treated by closed reduction between 6 and 24 months of age.

引用

页码：436 / 441

页数：6

共 44 条

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