Revista espanola de cirugia ortopedica y traumatologia · 2025
[Translated article] Early recovery of acetabular index in ddh as good prognosis factor after closed reduction and spica cast treatment.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
González-Herranz P, Penelas-Abelleira N, Rodríguez-Rodríguez M L, Goday-Etxebarria M
Аннотация
INTRODUCTION: Early diagnosis of DDH, ultrasonography and treatment with Pavlik arnais have provided an improvement of the results. However, always appear children more than 3 months until 24-months old with late diagnosis or failure with Pavlik treatment requiring closed reduction and spica cast treatment as standard management.
MATERIAL AND METHOD: The authors reviewed retrospectively DDH cases treated all patients treated with spica cast in human position during 3 months. The minimum follow-up was 5 years. It was considered good result when DDH reduced, remained stable, concentric, without AVN and not required surgery for sequels. All demographics, clinical and radiological parameters were statistically analyzed.
RESULTS: Of a total 152 hips were treated, 24 (15.8%) required surgery. In 6 cases (4%) was observed AVN. According IHDI/Tönnis displacement severity, types I and II were success treated in 98.9% and types III/IV in 64%. As bad prognosis factors were identified Ortolani test (+), alfa angle minor than 44°, acetabular index higher than 44° or IHDI/Tönnis types III/IV and factors for a good prognosis types I/II and the early recovery of the acetabular index more than 10° after 5 months of treatment. The age and early treatment of the patients was only important for the hips type III/IV (64 hips), the mean age of patients treated successfully was 5.1 months (64%), comparing with 8.8 months of the surgery group (36%). The incidence of AVN was 4% (6 cases) and in all cases the nucleus of ossification was not present in the X-ray pre-treatment. We cannot find relationship between AVN with previous skin traction, adductor tenotomy or severity of displacement.
CONCLUSIONS: Conservative management of DDH with spica cast provide excellent results in almost all cases in types I and II hips (98.9%) and in 64% of types III/IV. An improvement of the acetabular index more than 10°, 5 months after the treatment is the best prognosis factor for a good result.
MATERIAL AND METHOD: The authors reviewed retrospectively DDH cases treated all patients treated with spica cast in human position during 3 months. The minimum follow-up was 5 years. It was considered good result when DDH reduced, remained stable, concentric, without AVN and not required surgery for sequels. All demographics, clinical and radiological parameters were statistically analyzed.
RESULTS: Of a total 152 hips were treated, 24 (15.8%) required surgery. In 6 cases (4%) was observed AVN. According IHDI/Tönnis displacement severity, types I and II were success treated in 98.9% and types III/IV in 64%. As bad prognosis factors were identified Ortolani test (+), alfa angle minor than 44°, acetabular index higher than 44° or IHDI/Tönnis types III/IV and factors for a good prognosis types I/II and the early recovery of the acetabular index more than 10° after 5 months of treatment. The age and early treatment of the patients was only important for the hips type III/IV (64 hips), the mean age of patients treated successfully was 5.1 months (64%), comparing with 8.8 months of the surgery group (36%). The incidence of AVN was 4% (6 cases) and in all cases the nucleus of ossification was not present in the X-ray pre-treatment. We cannot find relationship between AVN with previous skin traction, adductor tenotomy or severity of displacement.
CONCLUSIONS: Conservative management of DDH with spica cast provide excellent results in almost all cases in types I and II hips (98.9%) and in 64% of types III/IV. An improvement of the acetabular index more than 10°, 5 months after the treatment is the best prognosis factor for a good result.