Effect of attention and interpretation therapy on posttraumatic stress disorder and perceived stress of parents with children having developmental dislocation of the hip / 中国实用护理杂志

Objective:To investigate the effect of attention and interpretation therapy on posttraumatic stress disorder and perceived stress of parents with children having developmental dislocation of the hip.Methods:Totally 96 parents with children having developmental dislocation of the hip from women and children hospital of Hubei province were divided into experimental group ( n=46) and control group ( n=46) according to the random number table method. The control group received routine postoperative DDH care. On the basis of this, the experimental group was given attention and interpretation therapy for 8 weeks. Before intervention and at the end of intervention, the effects were assessed by Posttraumatic Stress Checklist-Civilian Version (PCL-C) and Chinese Perceived Stress Scale (CPSS). Results:After intervention, the scores of arousal symptoms, avoidance/numbing, re-experiencing symptoms and total PCL-C scores were 8.47±2.30, 10.67±2.67, 7.49±2.63, 26.62±4.10, in addition, the scores of sense of tension, sense of out of control and total scores of CPSS were 11.71±2.21, 11.27±2.95, 22.98±3.77, which were significantly lower than those in the control group (9.45±2.33, 12.39±2.43, 8.93±2.79, 30.77±5.30, 12.86±3.05, 13.09±3.46, 25.95±4.52), the difference was statistically significant ( t value was 2.013-4.135, P<0.05). Conclusion:Attention and interpretation therapy can effectively relieve posttraumatic stress disorder symptom and alleviate perceived stress level of parents with children having developmental dislocation of the hip.

Application of new perioperative functional exercise combined with rehabilitation guidance in the treatment of developmental hip dislocation in children / 中国基层医药

Objective To explore and analyze the clinical application of perioperative functional exercise combined with rehabilitation guidance in the treatment of pediatric developmental hip dislocation.Methods From December 2015 to December 2017,40 children with developmental dislocation of the hip treated in Shengjing Hospital Affiliated to China Medical University were selected in the research.The patients were randomly divided into control group and observation group,with 20 cases in each group.The control group was given conventional perioperative rehabilitation guidance,the observation group was given new perioperative functional exercise combined with rehabilitation guidance.The limb function and mental status changes before and after the intervention were compared between the two groups.Results After intervention,the scores of FMA and Barthel were all increased in the two groups compared with those before intervention,and the improvements of the observation group wese more significant than those of the control group (all P ＜ 0.05).After intervention,the self-rating anxiety scale (SAS),self-rating depression scale (SDS),Hamilton depression scale(HAMD) and other negative emotions scores in the observation group were significantly lower than those in the control group (all P ＜ 0.05).Conclusion New perioperative functional exercise combined with rehabilitation guidance can effectively improve the limb function of children with developmental dislocation of the hip joint,at the same time improve the patients' mental state,and has positive significance to enhance the curative effect.

Prognostic Factors in Acetabular Development Following Reduction of Developmental Dislocation of the Hip in Patients under the Age of 24 Months / 대한정형외과학회잡지

PURPOSE: The aims of this study are to evaluate the outcome of treatment for developmental dislocation of the hip (DDH) in children under the age of 24 months who underwent open reduction (OR) or closed reduction (CR) and to determine radiologic prognostic factor. MATERIALS AND METHODS: A total of 90 hips of 88 children under the age of 24 months treated for DDH were included. The treatments for these children were CR in 29 hips and OR in 61 hips. All patients were followed up for more than 5 years. Radiographic evaluations, including acetabular index (AI), Yamamuro's distance a and b, center-edge angle (CEA), sourcil shape, and teardrop shape have been proposed to indicate the degree of DDH. Hips were reclassified according to the Severin criteria (classes I and II, satisfactory; classes III and IV, unsatisfactory). RESULTS: Among the 90 hips, 67 hips (74.4%) were included in the ‘satisfactory group’, while 23 hips (25.6%) were included in the ‘unsatisfactory group’. In the CR group, 23 hips (79.3%) were included in the ‘satisfactory group’, while 6 hips (20.7%) were included in the ‘unsatisfactory group’. In the OR group, 44 hips (72.1%) were included in the ‘satisfactory group’, while 17 hips (27.9%) were included in the ‘unsatisfactory group’. There was no significant difference between the reduction methods. At 1 year follow-up after reduction, the AI improvement in the ‘satisfactory group’ (8.1° [23.4%]) was significantly higher than that in the ‘unsatisfactory group’ (6.7° [18.5%]) (p=0.012). A significant difference of the mean CEA values was observed between the ‘satisfactory group’ and the ‘unsatisfactory group’ 3 years after the treatment (p=0.001). Five years after reduction, the V shape of teardrop and the upward shape of acetabular sourcil were observed in 2 hips (3.0%) and 4 hips (6.0%) of the ‘satisfactory group’, respectively, whereas the corresponding findings were observed in 3 hips (13.0%) and 5 hips (21.7%) of the ‘unsatisfactory group’, respectively (p=0.023, 0.005). CONCLUSION: The improvement of AI at 1-year and CEA at 3-year follow-ups, as well as teardrop shape and sourcil shape at 5-year followup, were reliable radiographic prognostic factor of DDH.

Application and effects of standard perioperative nursing operation procedure in children with developmental dislocation of the hip / 中华护理杂志

Objective To explore the effects of application of standard operation procedure (SOP) for perioperative nursing in children with developmental dislocation of the hip (DDH).Methods From March to September 2015,a total of 59 children with DDH were provided SOP for perioperative nursing.We retrospectively analyzed 50 cases of children with DDH treated with routine perioperative nursing admitted between June 2014 and December 2014.We compared the completeness of preoperative preparation,the incidence of postoperative complications and the parental satisfaction between two groups.Results Application of SOP for perioperative nursing increased the completeness of preoperative preparation,decreased the incidence of postoperative complications,and the parental satisfaction was greatly improved.Conclusion SOP for perioperative nursing for children with DDH can standardize nurses' working procedure,making nursing practice procedure much more specific,specified and clear,and can better guide clinical practice.

Application and effects of standard perioperative nursing operation procedure in children with developmental dislocation of the hip / 中华护理杂志

Objective To explore the effects of application of standard operation procedure (SOP) for perioperative nursing in children with developmental dislocation of the hip (DDH).Methods From March to September 2015,a total of 59 children with DDH were provided SOP for perioperative nursing.We retrospectively analyzed 50 cases of children with DDH treated with routine perioperative nursing admitted between June 2014 and December 2014.We compared the completeness of preoperative preparation,the incidence of postoperative complications and the parental satisfaction between two groups.Results Application of SOP for perioperative nursing increased the completeness of preoperative preparation,decreased the incidence of postoperative complications,and the parental satisfaction was greatly improved.Conclusion SOP for perioperative nursing for children with DDH can standardize nurses' working procedure,making nursing practice procedure much more specific,specified and clear,and can better guide clinical practice.

High developmental dislocation of the hip in patients with non bone cement (biological) and curative effect of total hip replacement operation method / 中国综合临床

Objective To investigate the clinical effect of high developmental dislocation of the hip in patients with total hip replacement operation to take biology.Methods Thirty-six cases of high developmental dislocation of the hip by patients as the object of study from January 2011 to February 2014 in the First People' s Hospital of Shangqiu, all patients underwent cementless total hip joint replacement operation, 6 months to 2 years after surgery, observed the clinical effect of all patients before and after treatemnt.Results The operation time was 1.20-3.0 h,the average operation time was (2.13±1.01) h,amount of bleeding during the operation of 300.00-700.00 ml,the average amount of bleeding was (342.43±34.23) ml;follow up of 6 months to 2 years, all patients had no prosthesis loosening and dislocation of the hip;all patients after treatment, Harris score (81.56± 14.34) points, better than that before treatment, the difference was statistically significant ((54.34 ± ±9.78) points,P=0.009);The excellent and good rate of all the patients after the treatment (97.22％) .Conclusion The clinical effect of high developmental dislocation of the hip by total hip replacement operation in patients taking biological type significantly, has the advantages of simple operation, effectively relieve pain, improve the life quality of patients and other advantages, the ideal treatment method can be used as high developmental dislocation of hip.

Anesthesia for a patient with Fanconi anemia for developmental dislocation of the hip: a case report / Anestesia em paciente com anemia de Fanconi e displasia do desenvolvimento do quadril: relato de caso / Anestesia en paciente con anemia de Fanconi y displasia del desarrollo de la cadera: caso clínico

Fanconi anemia is a rare autosomal recessive inherited bone marrow failure syndrome with congenital and hematological abnormalities. Literature regarding the anesthetic management in these patients is limited. A management of a developmental dislocation of the hip was described in a patient with fanconi anemia. Because of the heterogeneous nature, a patient with fanconi anemia should be established thorough preoperative evaluation in order to diagnose on clinical features. In conclusion, we preferred caudal anesthesia in this patient with fanconi anemia without thrombocytopenia, because of avoiding from N2O, reducing amount of anesthetic, existing microcephaly, hypothyroidism and elevated liver enzymes, providing postoperative analgesia, and reducing amount of analgesic used postoperatively.

A anemia de Fanconi é uma síndrome hereditária autossômica recessiva rara, caracterizada por deficiência da medula óssea e anomalias congênitas e hematológicas. A literatura sobre o manejo anestésico dos pacientes é limitada. O manejo de uma displasia do desenvolvimento do quadril foi descrito em um paciente com anemia de Fanconi. Por causa da natureza heterogênea, um paciente com anemia de Fanconi deve ser submetido à avaliação pré-operatória para diagnosticar as características clínicas. Em conclusão, o bloqueio caudal foi a nossa escolha para esse paciente com anemia de Fanconi, sem trombocitopenia, para evitar o N2O, reduzir a quantidade de anestésico, a microcefalia existente, o hipotireoidismo e o aumento das enzimas hepáticas, proporcionar analgesia pós-operatória e reduzir a quantidade de analgésico usada no pós-operatório.

La anemia de Fanconi es un síndrome hereditario autosómico recesivo raro, caracterizado por deficiencia de la médula ósea y por anomalías congénitas y hematológicas. La literatura sobre el manejo anestésico de esos pacientes es limitada. El manejo de una displasia del desarrollo de la cadera fue descrito en un paciente con anemia de Fanconi. Debido a la naturaleza heterogénea, un paciente con anemia de Fanconi debe ser sometido a la evaluación preoperatoria para diagnosticar las características clínicas. En conclusión, el bloqueo caudal fue nuestra elección para ese paciente con anemia de Fanconi sin trombocitopenia para evitar el N2O, reducir la cantidad de anestésico, microcefalia existente, hipotiroidismo y aumento de las enzimas hepáticas, proporcionar analgesia postoperatoria y reducir la cantidad de analgésico usado en el postoperatorio.

MRI study of the infantile developmental dislocation of the hip / 实用放射学杂志

Objective To investigate the diagnostic value of MRI in the infantile developmental dislocation of the hip.Methods Forty-five cases of preoperative hip MRI data of DDH (patient group)and 40 cases of normal hip (control group)MRI data were retrospectively analyzed.Three types were classified according to the standard of Dunn.Then the bony acetabular index (BAI),cartilaginous acetabular index (CAI)were measured on coronal MRI and all the intra-articular structures (articular cartilage,labrum, teres ligament and iliopsoas)in the acetabulum that impeded the reduction of the femoral head were observed.Results There were normal hips (80 hips)and dislocated hips (73 hips).In dislocated hips typeⅠ (30 hips),typeⅡ (20 hips),and typeⅢ (23 hips) were found.The values of BAI were (26.13±2.19)°and (35.87±4.42)°,CAI (13.84±1.07)°and (21.92±4.70)°for patient group and control group.The values of BAI were (31.80±1.74)°,(37.80±3.40)°and (39.17±4.11)°,CAI (17.20±2.68)°,(20.91±2.02)°and (27.50±2.78)°for the typesⅠ,Ⅱ,Ⅲ respectively.Differences of BAI and CAI between patient group and control group were showed (t=-11.048 and -9.188,P =0.000).Statistically significants were found among the typeⅠ,Ⅱ,Ⅲ(F=22.159 and 47.241,P =0.000).There were linear correlations for patient group ,control group,and the typeⅠ,Ⅱ,Ⅲ (r= 0.964,0.844,0.953,0.931 and 0.870,P =0.000).Some pathological changes such as varus labrum,thick teres ligament,iliopsoas spasm,articular cartilage hyperplasia,fat hyperplasia,joint effusion were observed in the type Ⅱand Ⅲ.Conclusion MRI is not only used for measuring the values of BAI and CAI,and a linear correlation among all kinds of DDH,but also some factors hindering the reduction of the femoral head can be found clearly.It can provide an important reference basis for the diagnosis and treatment of DDH.

Correlation research in different coping styles and psychological reaction of parents whose children with developmental dislocation of the hip / 中国实用护理杂志

Objective To understand the relevance of different coping styles and psychological reaction of the parents whose children with developmental dislocation of the hip (ODH). Methods To use symptom checklist (SCL-90) and simple coping style questionnaire, 96 parents of DDH children were questionnaired of the coping styles and psychological symptoms, and compared with the national norm, derived from the rating scale and the relationship between coping styles. Results Psychological symptom score of parents of DDH children was higher than the national norm, the psychological symptoms was objective, compared with the national norm, interpersonal sensitivity, depression, anxiety were statistically significant; interpersonal sensitivity, depression, anxiety was positively correlated with coping actively, somatization was positively correlated with the negative. Conclusions Parents of DDH children should be given more psychological counseling and psychological care,it may reduce the incidence of psychological symptoms,make them to take the right way to deal with.

Expression of COLlal and COL3al in the ligamentum teres of developmental dislocation of the hip / 中国矫形外科杂志

[Objective]To investigate the expression of collagen type I and III at mRNA and protein level in the ligamentum teres of developmental dislocation of the hip(DDH) and the normal hip. [Method]There were 6 pairs joint laxity of patients of DDH group and normal control group with paired control of same sex and age.Semiquantity RT-PCR method was used to detect the COLlal and COL3al in the ligamentum teres at mRNA level. Western-Blot method was used to detect the COLlal and COL3al in the ligamentum teres at protein level. The quantitative analysis of the COLlal and COL3al were performed by professional image software and the results were analyzed with standard statistical methods.[Result]At both mRNA and protein level COLlal expression were decreased in the DDH group compared to the control group(P0.05).[Conclusion]The decreased collagen I expression at mRNA and protein level in the ligamentum teres of the children with DDH may lead to hip joint laxity.Hip joint laxity in DDH may be independent to the content of collagen III.

Acetabular Development after Operative Treatment of Developmental Dislocation of the Hip / 대한정형외과학회잡지

PURPOSE: To examine the acetabular development after the surgical treatment of a developmental dislocation of the hip (DDH). MATERIALS AND METHODS: The serial radiographs of 27 hips were evaluated. The measurement included: acetabular index, CE angle, Smith's h/b, c/b ratio, medial joint space, and center-head distance discrepancy (CHDD). All the patients were followed up until they were at least 10 years old. The overall results were evaluated using the modified Severins classification (group I & II, satisfactory; group III & IV, unsatisfactory). RESULTS: In the satisfactory group, the average acetabular index at 1 and 3 years after the pelvic osteotomy was 6% were in the unsatisfactory group. CONCLUSION: The most reliable factors for predicting normal acetabular development after surgery were an acetabular index <25 degrees and a CHDD <6%. If the hips do not meet the criterion of a CHDD <6% after the osteotomy of one component (either the pelvic or femur) then the other component must be osteotomized.

Appilication of Femoral Neck Anteversion in Developmental Dislocation of the Hip by Digital Anatomy / 实用儿科临床杂志

Objective To discuss the femoral neck anteversion(FNA) of developmental dislocation of the hip(DDH) and guide operation with visual and digitalized picture in the dimensional(3D) CT.Methods Ninety children with unilateral DDH were selected,and they were analyzed using 3D CT.Children whose FNA exceed 45 degree received the subtrochanter osteotomy with images from different direction,FNA of hip was measured respectively before and after operation and was measured in normal and abnormal hips respectively,FNA of hip received respectively statistical treatment.Ninety patients (90 hips) were followed up ranging from 3 months to 2 years with the mean of 13 months.Results In the group younger than 18 months,the FNA whose in normal hips was(19.40?3.512)degree,the FNA while(68.45?12.272)degree in dysplasia hips respectively,the FNA measured after operation was (20.45?2.940) degree;in the group elder than 6 years,there were significantly statistical differences,the FNA in normal hips was(19.44?3.561)degree,in dysplasia hips respectively was(73.49?12.678)degree,while the FNA measured after operation was(18.28?1.931)degree.Clinical assessment was performed according to Mckay′s classification.The results showed that the overall excellent or good rate was 95.6%.Conclusions 3D CT method is a new accurate and convenient and reduplicative method for measuring FNA.It will be more helpful for related operations when 3D images are considered.

Hip Development after Reduction in Developmental Dislocation of the Hip: Long-term Follow-up to Skeletal Maturity of 64 Hips / 대한정형외과학회잡지

PURPOSE: The serial radiographs of 64 children with unilateral developmental dislocation of the hip (DDH) were reviewed in order to follow the natural hip development with age after a concentric reduction. MATERIALS AND METHODS: All patients were treated with a closed (22 patients) or open reduction (42 patients) and were followed up to the age of skeletal maturity. The radiographic measurements including the acetabular angle (AA), Sharp angle (SA), center-edge angle (CEA), acetabulum-head index (AHI) and neck-shaft angle (NSA) were obtained in 6 age groups; 0-2 years, 2-4, 4-8, 8-12, 12-16, 16 and over. RESULTS: The rate of acetabular development evaluated by both the AA and SA, was greatest before 4 years of age and continued to a lesser extent until skeletal maturity. The neck-shaft angle also continuously and gradually improved after the concentric reduction until skeletal maturity. Acetabular coverage of the femoral head, which was evaluated by the CEA and AHI, reached the normal level in the 8-12 year age group and was maintained a normal level through to skeletal maturity. CONCLUSION: The hip dysplasia continued to improve until skeletal maturity. Therefore, it is recommended that secondary surgery should not be performed if the X-ray shows continuous improvement and a concentric reduction is maintained.

Distribution and expression of PDGF-A in the ligamentum teres of children with developmental dislocation of the hip / 中国矫形外科杂志

[Objective] This study examined the distribution and the expression of platelet-derived growth factor-A (PDGF-A) in the ligamentum teres of children with developmental dislocation of the hip (DDH) and normal persons in order to investigate the roles of PDGF-A in hip joint laxity. [Methods]There were six pairs of joint laxity of children with DDH and normal children (control group) matched to gender and age. Immunohistochemistry (SP method) method was used to detect the location and distribution of the PDGF-A in the ligamentum teres,and to semi-quantify their content.Semiquantitative RT-PCR method was used to detect the PDGF-A in the ligamentum teres at mRNA level. The quantitative analysis of the PDGF-A was performed by professional image software and the results were analyzed with standard statistical methods.[Results]High density expression was observed in the synovial layer with fibroblast regularly arranged parallel to the joint surface in the ligamentum teres. PDGF-A distribution was decreased in the fibrous layer of the ligamentum teres. There were significant differences in the percentage of positive fibroblast and gray-scale density in the fibrous layer between DDH group and control group (P

Arthrographic Evaluation in Developmental Dislocation of the Hip: Comparison Between Hip Arthrogram and Operative Findings / 영남의대학술지

One of the main purposes in the treatment of developmental dislocation of the hip is to achieve and maintain concentric, congruent, and stable reduction. The arthrogram perform an important role in the diagnosis and treatment of developmental dislocation of the hip. The arthrogram provides much information about the soft tissue status of the hip joint. Limbus and ligamentum teres is exactly evaluated so we can plan the reduction and treatment before operation. 18 preoperative hip arthrograms of 17 children treated for developmental dislocation of the hip from 1992 to 1998 were reviewed. The limbus, ligamentum teres and transverse acetabular ligament were compared with the pathoanatomy seen at the time of open reduction. Arthrography proved reliable in identifying the limbus and ligamentum teres. So we recommend that arthrography must be performed before closed or open reduction. Also, we recorded the radiographic parameters: acetabular index, acetabular floor thickness, center edge(CE) angle of Wiberg, and Y-coordinate. The center edge(CE) angle of Wiberg obtained from arthrography was measured more accurately than from simple roentgenograms because the ossification of the femoral head was frequently located eccentrically in the developmental dislocation of the hip.

Application of Three-Dimensional Computed Tomography for Detecting Femoral Neck Anteversion in Development Dislocation of Hip in Children / 实用儿科临床杂志

Objective To evaluate the value of reconstruction of three-dimentional CT in development dislocation of hip(DDH)in children.Methods Twelve cases of DDH concluded 4 bilateral and 8 unilateral cases.To sum up,16 sick hips were operated and 8 normal hips were also obtained by three-dimensional CT(Hip speed Fi/x,GE Co).Results 3D reconstruction were used to show femoral head,(acetabulum) and relationship of acetabulum and femoral head respectively.The difference between FNA measurement of sick hips and those of normal hips were significant(P