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目的研究单侧发育性髋关节脱位(developmental dysplasia of the hip,DDH)患儿早期进行Pemberton截骨术(Pemberton’s pericapsular osteotomy,PPO)后的足底压力变化情况,为患者的手术治疗和康复提供有参考价值的生物力学结果。方法选取18名4岁前已行PPO的单侧DDH患儿作为实验组,同时以18名同年龄健康儿童作为对照组,采用Footscan足底压力测试系统进行动态足底压力测试。通过比较实验组与对照组足底各分区接触面积百分比(CA%)、压强时间积分(PTI)和站立相各分期时间百分比(CT%),评估行走状态下患者足底压力的变化。结果与对照组和患者健肢相比,患肢在第2~5趾区PTI较高,在足跟内侧区PTI较低。与健肢和对照组相比,患肢第4、5跖骨区CA%较大,而第1、2跖骨区CA%较健肢小。与健肢和对照组相比,患肢前足离地期CT%增大,足跟着地期CT%减少,且总的触地时间更短。结论 DDH患者在早期进行PPO后足底压力存在残余异常,临床中还需要长时间的强化康复治疗来矫正患者异常的足底压力分布。
Objective To study the changes of plantar pressure after Pemberton’s pericapsular osteotomy (PPO) in children with unilateral developmental dysplasia of the hip (DDH), and to provide the patients with surgical treatment and rehabilitation Reference biomechanical results. Methods Eighteen unilateral DDH children with PPO before 4 years old were selected as the experimental group. At the same time, 18 healthy children of the same age were selected as the control group. Footscan plantar pressure test system was used to carry out dynamic plantar pressure test. The changes of plantar pressure under walking condition were evaluated by comparing CA%, PTI, and CT% of each staging area in experimental group and control group. Results Compared with the control group and the healthy limbs, the PTI was higher in the 2nd to 5th toe area and lower in the medial area of the heel. Compared with the healthy limbs and the control group, the CA% of the metatarsal area in the fourth and fourth metatarsal limbs was larger and CA% in the first and second metatarsal areas was smaller than that in the healthy limbs. Compared with the healthy limbs and the control group, CT% of forelimb extremities increased, heel duration decreased with CT%, and the total touchdown time was shorter. Conclusion DDH patients have residual abnormalities of plantar pressure after early PPO. Long-term intensive rehabilitation is needed to correct the abnormal plantar pressure distribution in patients with DDH.