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ID 31850
JaLCDOI
フルテキストURL
著者
Ohmori, Takao Department of Orthopaedic Surgery, Kochi Health Sciences Center
Endo, Hirosuke Department of Orthopaedic Surgery, Okayama University Hospital
Mitani, Shigeru Department of Orthopaedic Surgery, Okayama University Hospital
Minagawa, Hiroshi Department of Orthopaedic Surgery, Okayama University Hospital
Tetsunaga, Tomonori Department of Orthopaedic Surgery, Okayama University Hospital
Ozaki, Toshifumi Department of Orthopaedic Surgery, Okayama University Hospital Kaken ID publons researchmap
抄録

In 1957, Pavlik introduced the Pavlik harness as a useful treatment for developmental dislocation of the hip (DDH), and subsequent studies have documented favorable outcomes among patients treated with this device. However, there are only a few articles reporting how early radiographic measurements can be used to determine the prognosis after treatment with the Pavlik harness. In this study, 217 hips from 192 patients whose DDH treatment with the Pavlik harness was initiated before they were 6 months old and whose follow-up lasted at least 14 years (rate, 63.8%) were analyzed using measurements from radiographs taken immediately before and after harness treatment, and at 1, 2, and 3 years of age. Severin's classification at the final follow-up was I or II in 71.9% and III or IV in 28.1% of the hips, respectively. Avascular necrosis of the femoral head (AVN) was seen in 10% of the hips. Stepwise multiple regression analysis was performed to retrospectively determine whether any radiographic factors were related to the final classification as Severin I/II or III/IV. Receiver opera-ting characteristic (ROC) curves were drawn for these factors, and a Wiberg OE angle (Point O was the middle point of the proximal metaphyseal border of the femur) of 2 degrees on the 3-year radiographs was found to be the most useful screening value for judging the acetabular development of DDH cases after treatment with a Pavlik harness, with a sensitivity of 71% a specificity of 93%, and a likelihood ratio of 10.1.

キーワード
developmental dislocation of the hip
long-term follow up
radiographic measurement
stepwise multiple regression analysis
acetabular development
Amo Type
Original Article
発行日
2009-06
出版物タイトル
Acta Medica Okayama
63巻
3号
出版者
Okayama University Medical School
開始ページ
123
終了ページ
128
ISSN
0386-300X
NCID
AA00508441
資料タイプ
学術雑誌論文
言語
English
論文のバージョン
publisher
査読
有り
PubMed ID
Web of Science KeyUT