当科における先天性股関節脱臼の治療経験

概要

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Pavlik harness is very useful method in the treatment of congenital dislocation of the hip of infants, but some dislocated hips cannot be reduced by the initial conservative treatment. We reviewed 11 hips of 11 patients (10 girls, 1 boy) affected by congenital dislocation of the hip which were treated initially with the Pavlik harness at our hospital from 2000 to 2004. Our study focused on the hips which were not reduced initially. The average age of the patients at the first visit was 3.3 months (range, 1.0-6.5 months), and the average age at the first treatment with the Pavlik harness was 3.7 months (range, 2.5-5.0 months). The average follow-up period was 22.3 months (range, 5.0-46.0 months). Nine hips were reduced with only the Pavlik harness between 3 to 18 days. Two of the 11 hips were not reduced initially, and underwent skin traction and open reduction. Though the severity of dislocation at the first visit was different, both of the hips were treated with the Pavlik harness for 5 to 8 weeks without reduction, and we suggest this treatment worsened the dislocation. We conclude that when the hip is not reduced by the initial treatment with Pavlik harness within 2 or 3 weeks, we should identify the factors obstructing the reduction, and consider subsequent treatments.
中国・四国整形外科学会の論文