Tuna PEHLİVANOĞLU, Serkan BAYRAM, Mehmet DEMİREL, Mustafa Abdullah ÖZDEMİR, Yavuz SAGLAM, Turgut AKGÜL, Fuat BİLGİLİ

İNSTABİL KALÇAYA SAHİP, 3-6 AYLIK HASTALARIN TEDAVİSİNDE PAVLİK BANDAJI ETKİNLİĞİNİN DEĞERLENDİRİLMESİ

Amaç: Üç ila altı aylık stabil olmayan kalça teşhisi konulan hastaların tedavisinde pavlik bandajın (PB) etkinliğinin araştırılması. Gereç ve Yöntem: Üç ila altı aylık stabil olmayan kalça teşhisi konulan ve pavlik bandajı ile tedavi edilen hastalar geriye dönük olarak incelendi. Hastaların stabil olmayan kalçaları PB kullanılarak tedavi edildi ve haftalık olarak klinik muayene ile yakından takip edildi. Birincil sonuç kriteri, stabil olmayan kalçaları olan çocuklarda PB tedavisinin başarı oranını değerlendirmekti (Graf’a göre tip IID, III, IV). Başarı kriterleri, Graf’ın kalça ultrasonografisi yöntemine göre tip I kalça veya kalça radyografisinde konsantrik redüksiyon elde edilmesi olarak tanımlandı. Bulgular: Bölümümüze ilk başvuru sırasında Graf yöntemine göre ultrasonografik muayene ile tanı konan 33 hasta ve 34 kalça çalışmaya dahil edildi. Pavlik bandajı tedavisinin başlangıcında çocukların ortalama yaşı 17 hafta (aralık, 14–22); ortalama takip süresi 48 ay (aralık, 24–84) olarak saptandı. Başvuru anında ortalama alfa açısı 46 (aralık, 35–58) olarak ölçüldü. Graf sınıflandırmasına göre GKD, 18 kalça Tip D (%52), 5 kalçada Tip IIIa, 3 (%24) tip IIIB ve 8 (%24) tip IV olarak saptandı. Bu 34 kalçadan 28’i (%82), ortalama 11,24 hafta (aralık, 4–20) uygulama süresi ile PB kullanılarak başarıyla tedavi edildi. PH tedavisinin başarı oranı %82 (28/34 kalça) olarak belirlendi. Sonuç: İnstabil kalçası olan (Graf Tip IID, III, IV) üç ila altı ay arasında tanı konulan hastalarda PB tedavisinden başarılı sonuçlar elde edilebilir.

Anahtar Kelimeler:

Gelişimsel kalça displazisi, Pavlik bandajı, bandaj tedavisi, tedavi başarı oranı, geç teşhis edilen gelişimsel kalça displazisi

ASSESSMENT OF PAVLIK HARNESS EFFECTIVENESS IN 3-6 MONTHS OLD PATIENTS WITH UNSTABLE HIPS

Objective: To investigate the effectiveness of the Pavlik harness (PH) in the treatment of patients who were diagnosed with unstable hips aged between three and six months. Material and Method: We retrospectively reviewed patients aged three to six months who were diagnosed with unstable hips and treated with the PH. The patients were treated using PH and were closely followed by a weekly clinical examination. The primary outcome was to assess the success rate of PH treatment in children with unstable hips (Graf Type IID, III, IV). A successful outcome as a result of PH treatment was defined as either obtaining a Type I hip based on Graf’s method of hip ultrasonography or a concentric reduction based on hip radiography. Results: Thirty-three patients’ 34 hips were included in this study with a diagnosis of DDH based on hip sonography performed according to the Graf’s method at the time of initial admission to our department. The mean age of the children in the beginning of the PH treatment was 17 weeks (range, 14–22); the mean follow- up was 48 months (range, 24–84). On admission, the mean alpha angle was 46 (range, 35–58). According to the Graf classification, DDH was determined as Type D in 18 hips (52%), Type IIIa in 5 hips, Type IIIB in 3 (24%) and Type IV in 8 (24%). Of these 34 hips, 28 (82%) were treated successfully using PH, with a mean application time of 11.24 weeks (range, 4–20). The success rate of PH treatment was determined as 82% (28/34 hips). Conclusions: Favorable outcomes can be expected from PH treatment in patients with unstable hips (Graf Type IID, III, IV) who are diagnosed between the age of three and six months.

Keywords:

Developmental dysplasia of the hip, Pavlik harness, harness treatment, treatment success rate, late-diagnosed hip dysplasia,

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