Chen Qiusheng,Li Xiongtao,Luo Sheng,et al.Joint release manipulation and repositioning combined with plus sequential orthopedic casts in the treatment of congenital knee dislocation in neonates[J].Journal of Clinical Pediatric Surgery,2025,(11):1065-1068.[doi:10.3760/cma.j.cn101785-202411058-014]
关节松动手法复位联合系列矫形石膏治疗新生儿先天性膝关节脱位的疗效分析
- Title:
- Joint release manipulation and repositioning combined with plus sequential orthopedic casts in the treatment of congenital knee dislocation in neonates
- Keywords:
- Knee Joint; Knee Dislocation; Orthopedics; Surgical Procedures; Operative; Child
- 摘要:
- 目的 探讨采用早期关节松动结合手法复位与石膏外固定对婴儿先天性膝关节脱位的临床疗效。方法 回顾性分析武汉儿童医院骨科2022年1月至2024年8月收治的先天性膝关节不同程度脱位的18例(27膝)患儿临床资料,其中男3例、女15例,初诊年龄为2 h至52 d。所有病例在石膏固定前行手法复位,随后行动态关节松动手法治疗,复位后用传统管型石膏矫形固定,并定期随访。测量患儿治疗前后膝关节屈伸活动度,采用Harris评分评估患儿膝关节功能恢复情况。结果 18例治疗前伸膝角度为(-64.26±12.41)°,治疗后伸膝角度为(1.81±1.59)°;治疗前屈膝角度为(50.74±12.57)°,治疗后屈膝角度为(139.15±14.41)°。对比患儿治疗前后伸膝角度和屈膝角度,差异均有统计学意义(P＜0.01)。按照Harris评分标准评定疗效:优14例,良1例,中2例,差1例;优良率为83.33％(15/18)。结论 先天性膝关节脱位患儿经关节松动术手法复位与矫形石膏治疗后,可明显改善患儿膝关节异常畸形,治疗效果良好,具有一定的临床推广价值。
- Abstract:
- Objective To explore the clinical efficacy of using early joint loosening plus manipulative repositioning and plaster external fixation for congenital knee dislocation in infants. Methods Retrospective review was performed for the relevant clinical data of 18 children (27 knees) of congenital knee dislocation of varying degrees hospitalized from January 2022 to August 2024.There were 3 boys and 15 girls with an initial diagnostic age of 2 hours to 52 days.Manipulation was performed for resetting joints before cast immobilization and dynamic joint loosening manipulation subsequently.The joints were orthopedically immobilized with raditional tubular casts after resetting.Regular follow-ups were conducted.Knee flexion and extension mobility were assessed before and after treatment.Harris score was utilized for assess the recovery of knee function. Results Knee extension angle was (-64.26±12.41)°pre-treatment and (1.81±1.59)°post-treatment; knee flexion angle was (50.74±12.57)°pre-treatment and (139.15±14.41)°.Both differences were statistically significant.Harris score was utilized for assessing the recovery of knee function (P<0.01).According to the Harris score,the outcomes were excellent (n=14),decent (n=1),medium (n=2) and poor (n=1).The excellent and good rate was 83.33%(15/18). Conclusions Congenital knee dislocation children can significantly improve the abnormal deformity of children’s knee joints after the treatment of arthrotomy manipulative reset and orthopedic cast,the treatment effect is good,and it has a certain clinical promotion value.
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备注/Memo
收稿日期:2024-11-27。
基金项目:武汉市卫健委科研项目(WX23A10);武汉儿童医院"腾飞计划"临床研究类项目(2023TFJH01)
通讯作者:沈先涛,Email:xtshenwh@aliyun.com