Araştırma Makalesi


DOI :10.26650/IUITFD.2021.879703   IUP :10.26650/IUITFD.2021.879703    Tam Metin (PDF)

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

Tuna PehlivanoğluSerkan BayramMehmet DemirelMustafa Abdullah ÖzdemirYavuz SağlamTurgut AkgülFuat Bilgili

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 değerlendirme, 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 bu 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 saptandı. 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) 3 ila 6 ay arasında tanı konulan hastalarda PB tedavisinden başarılı sonuçlar elde edilebilir. 

DOI :10.26650/IUITFD.2021.879703   IUP :10.26650/IUITFD.2021.879703    Tam Metin (PDF)

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

Tuna PehlivanoğluSerkan BayramMehmet DemirelMustafa Abdullah ÖzdemirYavuz SağlamTurgut AkgülFuat Bilgili

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.


PDF Görünüm

Referanslar

  • 1. Kokavec M, Makai F, Olos M, Bialik V. Pavlik’s method: a retrospective study. Arch Orthop Trauma Surg 2006;126(2):73-6. [CrossRef] google scholar
  • 2. Pollet V, Pruijs H, Sakkers R, Castelein R. Results of Pavlik harness treatment in children with dislocated hips between the age of six and twenty-four months. J Pediatr Orthop 2010;30(5):437-42. [CrossRef] google scholar
  • 3. Westacott DJ, Mackay ND, Waton A, Webb MS, Henman P, Cooke SJ. Staged weaning versus immediate cessation of Pavlik harness treatment for developmental dysplasia of the hip. J Pediatr Orthop B 2014;23(2):103-6. [CrossRef] google scholar
  • 4. Atalar H, Sayli U, Yavuz OY, Uraş I, Dogruel H. Indicators of successful use of the Pavlik harness in infants with developmental dysplasia of the hip. Int Orthop 2007;31(2):145-50. [CrossRef] google scholar
  • 5. Omeroglu H, Kose N, Akceylan A. Success of Pavlik Harness Treatment Decreases in Patients > 4 Months and in Ultrasonographically Dislocated Hips in Developmental Dysplasia of the Hip. Clin Orthop Relat Res 2016;474(5):1146-52. [CrossRef] google scholar
  • 6. Cashman J, Round J, Taylor G, Clarke N. The natural history of developmental dysplasia of the hip after early supervised treatment in the Pavlik harness. J Bone Joint Surg Br 2002;84(3):418-25. [CrossRef] google scholar
  • 7. Harding MG, Harcke HT, Bowen JR, Guille JT, Glutting J. Management of dislocated hips with Pavlik harness treatment and ultrasound monitoring. J Pediatr Orthop 1997;17(2):189-98. [CrossRef] google scholar
  • 8. Viere R, Birch J, Herring J, Roach J, Johnston C. Use of the Pavlik harness in congenital dislocation of the hip. An analysis of failures of treatment. J Bone Joint Surg Am 1990;72(2):238-44. [CrossRef] google scholar
  • 9. Lerman JA, Emans JB, Millis MB, Share J, Zurakowski D, Kasser JR. Early failure of Pavlik harness treatment for developmental hip dysplasia: clinical and ultrasound predictors. J Pediatr Orthop 2001;21(3):348-53. [CrossRef] google scholar
  • 10. Uçar DH, Isklar ZU, Kandemir U, Tümer Y. Treatment of developmental dysplasia of the hip with Pavlik harness: prospective study in Graf type IIc or more severe hips. J Pediatr Orthop B 2004;13(2):70-4. [CrossRef] google scholar
  • 11. Thieme WT, Thiersch JB. Translation: Hilgenreiner on congenital hip dislocation. J Pediatr Orthop 1986;6(2):202-14. [CrossRef] google scholar
  • 12. Kalamchi A, MacEwen GD. Avascular necrosis following treatment of congenital dislocation of the hip. J Bone Joint Surg Am 1980;62(6):876-88. [CrossRef] google scholar
  • 13. Tönnis D. Normal values of the hip joint for the evaluation of X-rays in children and adults. Clin Orthop Relat Res 1976;119:39-47. [CrossRef] google scholar
  • 14. Westacott DJ, Mackay ND, Waton A, Webb MS, Henman P, Cooke SJ. Staged weaning versus immediate cessation of Pavlik harness treatment for developmental dysplasia of the hip. J Pediatr Orthop B 2014;23(2):103-6. [CrossRef] google scholar
  • 15. Nakamura J, Kamegaya M, Saisu T, Someya M, Koizumi W, Moriya H. Treatment for developmental dysplasia of the hip using the Pavlik harness. J Bone Joint Surg Br 2007;89(2):230-5. [CrossRef] google scholar
  • 16. Ramsey P, Lasser S, MacEwen G. Congenital dislocation of the hip. Use of the Pavlik harness in the child during the first six months of life. J Bone Joint Surg Am 1976;58(7):1000-4. [CrossRef] google scholar
  • 17. Larson JE, Patel AR, Weatherford B, Janicki JA.J. Timing of Pavlik Harness Initiation: Can We Wait? J Pediatr Orthop 2019;39(7):335-8. [CrossRef] google scholar
  • 18. Tiruveedhula M, Reading IC, Clarke NM. Failed Pavlik harness treatment for DDH as a risk factor for avascular necrosis. J Pediatr Orthop 2015;35(2):140-3. [CrossRef] google scholar
  • 19. Kitoh H, Kawasumi M, Ishiguro N. Predictive factors for unsuccessful treatment of developmental dysplasia of the hip by the Pavlik harness. J Pediatr Orthop 2009;29(6):552-7. [CrossRef] google scholar
  • 20. Suzuki SG, Yamamuro T. Avascular necrosis in patients treated with the Pavlik harness for congenital dislocation of the hip. J Bone Joint Surg Am 1990;72(7):1048-55. [CrossRef] google scholar
  • 21. Fujioka F, Terayama K, Sugimoto N, Tanikawa H. Long-term results of congenital dislocation of the hip treated with the Pavlik harness. J Pediatr Orthop 1995;15(6):747-52. [CrossRef] google scholar
  • 22. Tucci JJ, Kumar SJ, Guille JT, Rubbo ER. Late acetabular dysplasia following early successful Pavlik harness treatment of congenital dislocation of the hip. J Pediatr Orthop 1991;3(4):502-5. [CrossRef] google scholar
  • 23. Carsi B, Al-Hallao S, Wahed K, Page J, Clarke NM. Incomplete periacetabular acetabuloplasty. Acta Orthop 2014;85(1):66-70. [CrossRef] google scholar

Atıflar

Biçimlendirilmiş bir atıfı kopyalayıp yapıştırın veya seçtiğiniz biçimde dışa aktarmak için seçeneklerden birini kullanın


DIŞA AKTAR



APA

Pehlivanoğlu, T., Bayram, S., Demirel, M., Özdemir, M.A., Sağlam, Y., Akgül, T., & Bilgili, F. (2021). İNSTABİL KALÇAYA SAHİP, 3-6 AYLIK HASTALARIN TEDAVİSİNDE PAVLİK BANDAJI ETKİNLİĞİNİN DEĞERLENDİRİLMESİ. İstanbul Tıp Fakültesi Dergisi, 84(3), 342-347. https://doi.org/10.26650/IUITFD.2021.879703


AMA

Pehlivanoğlu T, Bayram S, Demirel M, Özdemir M A, Sağlam Y, Akgül T, Bilgili F. İNSTABİL KALÇAYA SAHİP, 3-6 AYLIK HASTALARIN TEDAVİSİNDE PAVLİK BANDAJI ETKİNLİĞİNİN DEĞERLENDİRİLMESİ. İstanbul Tıp Fakültesi Dergisi. 2021;84(3):342-347. https://doi.org/10.26650/IUITFD.2021.879703


ABNT

Pehlivanoğlu, T.; Bayram, S.; Demirel, M.; Özdemir, M.A.; Sağlam, Y.; Akgül, T.; Bilgili, F. İNSTABİL KALÇAYA SAHİP, 3-6 AYLIK HASTALARIN TEDAVİSİNDE PAVLİK BANDAJI ETKİNLİĞİNİN DEĞERLENDİRİLMESİ. İstanbul Tıp Fakültesi Dergisi, [Publisher Location], v. 84, n. 3, p. 342-347, 2021.


Chicago: Author-Date Style

Pehlivanoğlu, Tuna, and Serkan Bayram and Mehmet Demirel and Mustafa Abdullah Özdemir and Yavuz Sağlam and Turgut Akgül and Fuat Bilgili. 2021. “İNSTABİL KALÇAYA SAHİP, 3-6 AYLIK HASTALARIN TEDAVİSİNDE PAVLİK BANDAJI ETKİNLİĞİNİN DEĞERLENDİRİLMESİ.” İstanbul Tıp Fakültesi Dergisi 84, no. 3: 342-347. https://doi.org/10.26650/IUITFD.2021.879703


Chicago: Humanities Style

Pehlivanoğlu, Tuna, and Serkan Bayram and Mehmet Demirel and Mustafa Abdullah Özdemir and Yavuz Sağlam and Turgut Akgül and Fuat Bilgili. İNSTABİL KALÇAYA SAHİP, 3-6 AYLIK HASTALARIN TEDAVİSİNDE PAVLİK BANDAJI ETKİNLİĞİNİN DEĞERLENDİRİLMESİ.” İstanbul Tıp Fakültesi Dergisi 84, no. 3 (Dec. 2024): 342-347. https://doi.org/10.26650/IUITFD.2021.879703


Harvard: Australian Style

Pehlivanoğlu, T & Bayram, S & Demirel, M & Özdemir, MA & Sağlam, Y & Akgül, T & Bilgili, F 2021, 'İNSTABİL KALÇAYA SAHİP, 3-6 AYLIK HASTALARIN TEDAVİSİNDE PAVLİK BANDAJI ETKİNLİĞİNİN DEĞERLENDİRİLMESİ', İstanbul Tıp Fakültesi Dergisi, vol. 84, no. 3, pp. 342-347, viewed 23 Dec. 2024, https://doi.org/10.26650/IUITFD.2021.879703


Harvard: Author-Date Style

Pehlivanoğlu, T. and Bayram, S. and Demirel, M. and Özdemir, M.A. and Sağlam, Y. and Akgül, T. and Bilgili, F. (2021) ‘İNSTABİL KALÇAYA SAHİP, 3-6 AYLIK HASTALARIN TEDAVİSİNDE PAVLİK BANDAJI ETKİNLİĞİNİN DEĞERLENDİRİLMESİ’, İstanbul Tıp Fakültesi Dergisi, 84(3), pp. 342-347. https://doi.org/10.26650/IUITFD.2021.879703 (23 Dec. 2024).


MLA

Pehlivanoğlu, Tuna, and Serkan Bayram and Mehmet Demirel and Mustafa Abdullah Özdemir and Yavuz Sağlam and Turgut Akgül and Fuat Bilgili. İNSTABİL KALÇAYA SAHİP, 3-6 AYLIK HASTALARIN TEDAVİSİNDE PAVLİK BANDAJI ETKİNLİĞİNİN DEĞERLENDİRİLMESİ.” İstanbul Tıp Fakültesi Dergisi, vol. 84, no. 3, 2021, pp. 342-347. [Database Container], https://doi.org/10.26650/IUITFD.2021.879703


Vancouver

Pehlivanoğlu T, Bayram S, Demirel M, Özdemir MA, Sağlam Y, Akgül T, Bilgili F. İNSTABİL KALÇAYA SAHİP, 3-6 AYLIK HASTALARIN TEDAVİSİNDE PAVLİK BANDAJI ETKİNLİĞİNİN DEĞERLENDİRİLMESİ. İstanbul Tıp Fakültesi Dergisi [Internet]. 23 Dec. 2024 [cited 23 Dec. 2024];84(3):342-347. Available from: https://doi.org/10.26650/IUITFD.2021.879703 doi: 10.26650/IUITFD.2021.879703


ISNAD

Pehlivanoğlu, Tuna - Bayram, Serkan - Demirel, Mehmet - Özdemir, MustafaAbdullah - Sağlam, Yavuz - Akgül, Turgut - Bilgili, Fuat. İNSTABİL KALÇAYA SAHİP, 3-6 AYLIK HASTALARIN TEDAVİSİNDE PAVLİK BANDAJI ETKİNLİĞİNİN DEĞERLENDİRİLMESİ”. İstanbul Tıp Fakültesi Dergisi 84/3 (Dec. 2024): 342-347. https://doi.org/10.26650/IUITFD.2021.879703



ZAMAN ÇİZELGESİ


Gönderim24.02.2021
Kabul14.04.2021
Çevrimiçi Yayınlanma13.07.2021

LİSANS


Attribution-NonCommercial (CC BY-NC)

This license lets others remix, tweak, and build upon your work non-commercially, and although their new works must also acknowledge you and be non-commercial, they don’t have to license their derivative works on the same terms.


PAYLAŞ




İstanbul Üniversitesi Yayınları, uluslararası yayıncılık standartları ve etiğine uygun olarak, yüksek kalitede bilimsel dergi ve kitapların yayınlanmasıyla giderek artan bilimsel bilginin yayılmasına katkıda bulunmayı amaçlamaktadır. İstanbul Üniversitesi Yayınları açık erişimli, ticari olmayan, bilimsel yayıncılığı takip etmektedir.