| Objective:By wearing Tübingenn harness for children with DDH,comparing the treatment effects and complications,evaluating the hip joint reduction of Tübingenn harness for children with DDH,and providing theoretical basis for the clinical use and promotion of Tübingenn harness.Methods:Retrospective analysis from January 2015 to December 2017,which was admitted to the orthopaedic clinic of children's hospital affiliated to the Kunming medical university.Whose hip ultrasound examination showed Graf classification?c or higher classification,and all were treated with Tübingenn harness.A total of 71 children including 96 hips were screened,including 13 males and 58 females.The data were complete and followed up until at least 12 months of age.The initial treatment was 1 to 20 weeks old,and the average initial treatment age was 8.3 weeks.The changes of the a angle of the ultrasound were observed.The last follow-up X-ray film measured the acetabular index(AI),and the final judgment of each child according to the IHDI classification.The hip joint was placed on the femoral head and the presence of Avascular necrosis of femoral head was determined according to the Bucholz and Ogeden classification.The data obtained were calculated by SPSS 24.0(IBM SPSS Statistics 24.0)statistical software.The measurement data were analyzed by independent sample T test.The count samples were analyzed Fisher's exact test.The P<0.05 was statistically significant.Results:All children were followed up to 12 to 42 months of age,with an average number of 18.6 months.? There are 71 children including 96 hips were included in the study,of which 74 hips(77.08%)were successfully treated by Tübingenn harness,no AVN occurred according to the Bucholz-Ogeden grade,and the 74 hips of the last hip X-ray were grade I according to IHDI.22 hips(22.91%)failed by Tübingenn harness treatment.? Among the Graf classification of 96 hips,There are 61 hips Type ?(including Type ?c and Type D),57 hips were successfully treated,with a treatment success rate of 93.44%.There are 14 hips being classified Type ?,among them 10 hips were successfully treated,and the treatment success rate was 71.43%.Of the 21 hips being classified Type IV,7 hips were successfully treated,and the treatment success rate was 33.33%.Different classifications are statistically significant(P<0.05)? Univariate analysis of variance was performed on children with successful treatment.The treatment success rate for male children was 84.62%.The treatment success rate of female children was 79.31%,and the difference was not statistically significant(P=1.000).The success rate of children with unilateral disease was 86.96%,and the success rate of children with bilateral disease was 68.00%.There was no significant difference(P=0.068).According to the wearing time,the success rate of children who started treatment before 7 weeks was 90.00%,and the success rate of children who started treatment after 7 weeks was 67.74%,Different classifications are statistically significant(P=0.033).? The duration time of children with successful harness treatment,according to the Graf classification,it is concluded that the time required for type ?c outcome is 8.13±3.35 weeks,the time required for type D outcome is 8.81±3.03 weeks,and type ? outcomes The required time was 8.90±3.25 weeks,and the type ?outcome time was 14.00±3.00 weeks.After analysis of variance,the time required for the four types of outcomes was statistically significant(P=0.02).Further LSD-t tests were performed,except for the differences between type IV and type ?c,type D,and type ?(?c-? p=0.000,D-? p=0.001,?-?=0.003),there was no statistical significance between the other groups(P>0.05).Conclusion(s):For children with DDH,The treatment of Tübingenn harness before 6 months of age is an effective measure.The treatment effect has no significant relationship with gender and unilateral or bilateral.The treatment start time of 7 weeks old Before the treatment effect is better than later,children with Graf type IV had a higher treatment failure rate,and the splint wear time was longer than other types. |
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