骨化核对儿童发育性髋关节发育不良治疗时机选择的研究进展

发育性髋关节发育不良(DDH)是常见的出生缺陷。治疗的主要目的是获得稳定的同心圆复位。早发现、早治疗是获得良好预后的关键。然而,对骨化核缺失时期的DDH复位可能会导致骨缺血性坏死(AVN)的顾虑,使得很多医师延迟进行复位治疗。但当骨化核出现时才进行复位,就错过了骨质重建潜能的最佳时期,从而增加二期手术风险。本文回顾近年来骨化核和缺血性坏死关系的相关性研究文献,讨论骨化核的保护机制及延迟治疗的代价,旨在为临床诊疗提供借鉴。

Research progress of relationship between ossific nucleus and treatment opportunity in children with developmental dysplasia of the hip

Developmental dysplasia of the hip(DDH) is a common birth defect. The main aim of treatment for DDH is to achieve stable and concentric reduction. Early diagnosis and treatment are the key to a good prognosis. The increased risk of avascular necrosis(AVN) in hips with an absent ossific nucleus has led some surgeons to delay reduction in the treatment of DDH until the ossific nucleus presents. Delayed reduction until the ossific nucleus appears bypasses the best period of maximal osseous remodeling of the hip, thereby possibly increasing the need for future operations. This paper reviewed the studies regarding the association between the status of the ossific nucleus and development of AVN, and the protective mechanism of ossific nucleus and the influence of delayed treatment, in order to provide a comprehensive understanding and method for management of DDH.