手法與樹脂夾板治療嬰兒先天性膝關(guān)節(jié)脫位
發(fā)布時間：2019-04-19 04:30
【摘要】：[目的]探討采用手法矯正后高分子樹脂石膏固定治療嬰兒先天性膝關(guān)節(jié)脫位的方法及療效。[方法]2009年12月~2016年11月共收治先天性膝關(guān)節(jié)脫位患兒26例(32膝),其中女22例,男4例,首診年齡1 h~1個月27 d,單純脫位9例9膝,復(fù)合畸形14例18膝,綜合征3例5膝。每日白天手法矯正逐漸增加膝關(guān)節(jié)屈曲角度,夜間采用可重復(fù)利用高分子夾板固定,達到復(fù)位后以石膏或支具維持至膝關(guān)節(jié)穩(wěn)定,治療后定期隨訪。[結(jié)果]所有病例均獲得6個月~7年的隨訪。單純性脫位與復(fù)合畸形患兒27膝關(guān)節(jié)過伸消失,膝關(guān)節(jié)屈曲功能完全恢復(fù)(100%);合并多發(fā)性關(guān)節(jié)攣縮癥患兒中3膝主動屈曲角度達140°以上,關(guān)節(jié)屈曲功能恢復(fù),1膝主動屈曲角度達120°左右,關(guān)節(jié)屈曲功能基本恢復(fù),能達到正常生活需要,1例合并Crouzon綜合征患兒,1膝屈曲有改善但未達到正常生活需要,需要手術(shù)治療;三組間治療前關(guān)節(jié)活動度比較差異無統(tǒng)計學意義(P0.05),但治療后綜合征患者與單純脫位患者、復(fù)合畸形患者的屈膝位ROM差異有統(tǒng)計學意義(P0.05)。本組全脫位10膝,半脫位22膝。末次隨訪時整體優(yōu)良率為96.88%,而且無論全脫位還是半脫位,膝關(guān)節(jié)治療效果差異無統(tǒng)計學意義(P0.05),其中:半脫位22膝、全脫位8膝關(guān)節(jié)功能評估"優(yōu)"(93.75%);1膝綜合征患兒為"良"(3.12%),1膝合并Crouzon綜合征患兒為"差"(3.12%)。[結(jié)論]患有先天性膝關(guān)節(jié)全脫位及半脫位的嬰兒,無論是否合并畸形,可以采用每日白天手法矯正,夜間高分子樹脂石膏固定進行治療,避免手術(shù)治療的創(chuàng)傷。
[Abstract]:[objective] to investigate the treatment of congenital dislocation of knee joint with high molecular resin plaster fixation after manual correction. [methods] from December 2009 to November 2016, 26 cases (32 knees) of congenital dislocation of knee joint were treated. Among them, 22 cases were female and 4 cases were male. The age of first diagnosis was 1 h / month 27 days, 9 cases (9 knees) with simple dislocation, 14 cases (18 knees) with complex deformity, and 9 cases (9 knees) with simple dislocation. 3 cases (5 knees) with syndrome. Day-to-day manual correction gradually increased the flexion angle of knee joint. At night, the knee joint was fixed with reusable polymer splint. The knee joint was stabilized by plaster or brace after reduction, and was followed up regularly after treatment. [results] all cases were followed up for 6 months to 7 years. In the children with simple dislocation and complex deformity, the overextension of the knee joint disappeared and the flexion function of the knee joint recovered completely (100%). In the children with multiple joint contracture, the active flexion angle of 3 knees was more than 140 擄, the joint flexion function was restored, and the active flexion angle of one knee was about 120 擄. The joint flexion function was basically restored, which could meet the needs of normal life. One child with Crouzon syndrome had improved knee flexion but did not meet the needs of normal life and needed surgical treatment. There was no significant difference in joint mobility between the three groups before treatment (P0.05), but there was a significant difference in knee flexion ROM between patients with syndrome and simple dislocation and complex deformity after treatment (P0.05). Total dislocation in 10 knees and subluxation in 22 knees. At the last follow-up, the overall excellent and good rate was 96.88%, and there was no significant difference in the treatment effect of knee joint between total dislocation and subluxation (P0.05), among which 22 knees were subluxated. Total dislocation 8 knee joint function evaluation "excellent" (93.75%); One knee syndrome was "good" (3.12%), and one knee complicated with Crouzon syndrome was "poor" (3.12%). [conclusion] infants with congenital total dislocation or subluxation of knee joint can be treated with day-to-day manual correction and night-time high molecular resin plaster fixation, no matter whether they are complicated with deformity or not, so as to avoid the trauma of surgical treatment.
【作者單位】： 河北省兒童醫(yī)院;
【分類號】：R726.8
本文編號：2460599
[Abstract]:[objective] to investigate the treatment of congenital dislocation of knee joint with high molecular resin plaster fixation after manual correction. [methods] from December 2009 to November 2016, 26 cases (32 knees) of congenital dislocation of knee joint were treated. Among them, 22 cases were female and 4 cases were male. The age of first diagnosis was 1 h / month 27 days, 9 cases (9 knees) with simple dislocation, 14 cases (18 knees) with complex deformity, and 9 cases (9 knees) with simple dislocation. 3 cases (5 knees) with syndrome. Day-to-day manual correction gradually increased the flexion angle of knee joint. At night, the knee joint was fixed with reusable polymer splint. The knee joint was stabilized by plaster or brace after reduction, and was followed up regularly after treatment. [results] all cases were followed up for 6 months to 7 years. In the children with simple dislocation and complex deformity, the overextension of the knee joint disappeared and the flexion function of the knee joint recovered completely (100%). In the children with multiple joint contracture, the active flexion angle of 3 knees was more than 140 擄, the joint flexion function was restored, and the active flexion angle of one knee was about 120 擄. The joint flexion function was basically restored, which could meet the needs of normal life. One child with Crouzon syndrome had improved knee flexion but did not meet the needs of normal life and needed surgical treatment. There was no significant difference in joint mobility between the three groups before treatment (P0.05), but there was a significant difference in knee flexion ROM between patients with syndrome and simple dislocation and complex deformity after treatment (P0.05). Total dislocation in 10 knees and subluxation in 22 knees. At the last follow-up, the overall excellent and good rate was 96.88%, and there was no significant difference in the treatment effect of knee joint between total dislocation and subluxation (P0.05), among which 22 knees were subluxated. Total dislocation 8 knee joint function evaluation "excellent" (93.75%); One knee syndrome was "good" (3.12%), and one knee complicated with Crouzon syndrome was "poor" (3.12%). [conclusion] infants with congenital total dislocation or subluxation of knee joint can be treated with day-to-day manual correction and night-time high molecular resin plaster fixation, no matter whether they are complicated with deformity or not, so as to avoid the trauma of surgical treatment.
【作者單位】： 河北省兒童醫(yī)院;
【分類號】：R726.8
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