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.

Closed reduction under general anesthesia and plaster fixation in human position are commonly applied for treating developmental dislocation of the hip (DDH) under an age of 24 months. However, around 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 controlled 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 dysplasia 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 dysplasia after closed reduction of DDH. [ABSTRACT FROM AUTHOR]