先天性肌性斜颈伴发育性髋关节异常儿童的康复治疗

目的了解先天性肌性斜颈（CMT）伴发育性髋关节异常（DDH）发生情况及其康复治疗的效果。方法对187例月龄〈2个月的CMT患儿，应用Graf方法行双侧髋关节B超、骨盆X线摄片检查以明确诊断，筛查DDH并对其髋关节类型进行分类。CMT采用手法推拿、磁贴、家庭体位矫治、热敷治疗，DDH采用屈髋外展支架、外展位石膏治疗，观察早期康复治疗的效果。结果187例CMT患儿中，24例（12．8％）合并DDH；髋关节类型：Ⅱb型22例（91．7％），Ⅲa型2例（8．3％）。24例患儿通过早期康复和屈髋外展支具治疗，共存疾病完全恢复正常。结论CMT和DDH有较高的共存比例，B超检查可以作为CMT新生儿筛查DDH的手段。同时对CMT和DDH进行早期康复治疗是有效的。

Rehabilitation management of congenital muscular torticollis coexisted with developmental dysplasia of the hip in children

Objective Congenital muscular torticollis (CMT) and developmental dysplasia of the hip (DDH) are common congenital problems in infants. Association between CMT and DDH has been reported in literatures. The aim of this study was to assess coexistence of DDH in infants with CMT and curative effects of its rehabilitative therapy. Methods In total, 187 infants less than two months old with CMT were recruited in the study. DDH was diagnosed and graded by Graf's bilateral hip type B ultrasonography and pelvic X-ray films. Massage manipulation, magnetic strapping, postural orthosis at home and heat compress were instituted for CMT and frog spica device and hip-flexion abduction plaster immobilization were instituted for DDH. Their early rehabilitative effects were evaluated. Results DDH was coexisted in 24 of 187 infants with CMT, with incidence of 12. 8%. The hips of 22 infants were graded as type Ⅱ b (91.7%) and two as type Ⅲ a (8.3%), and eight at the left side and seven at the right side.Comorbid hips completely recovered normal with early frog spica device and hip-flexion abduction therapy in 24 infants. Conclusions Coexistence of CMT and DDH are relatively common in infants. Type B ultrasonography can be used as a measure for screening DDH in neonates with CMT. Early rehabilitative therapy is effective for those coexisted with DDH and CMT at the same time.