兒童髖關節手術過程中藥物使用時機

Timing of Drug Use During Pediatric Osteotomy

髖關節發育不良(Developmental dysplasia of the hip, DDH)是新生兒中最常見的骨骼肌肉疾病之一。包含髖關節疾病，範圍由輕度髖臼發育不良到髖關節完全脫位。新生兒身體檢查幫助早期診斷和治療是重要的。新生兒在危險因子包括臀位、頭胎、有DDH家族病史或髖關節不穩定，超音波篩檢髖關節診斷是有幫助。治療上有幾種方式，最常見是新生兒使用吊帶(Pavlik harness)。吊帶將臀部保持固定位置，使臀部穩定並適當的關節發育。早期治療對於髖關節發育是重要的。吊帶(Pavlik harness)以外的治療方式包括靜態支撐、手術閉合復位、切開復位以及髖臼或股骨截骨矯正術。若要髖臼或股骨截骨矯正術過程需要評估藥物使用時機與劑量。

Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal disorders among newborns. It involves a spectrum of disease of the hip joint, ranging from mild dysplasia of the acetabulum to complete dislocation of the hip. It is important to diagnose and treat early, and there are several physical exam findings that can help diagnose the disorder in the newborn. Screening with ultrasound of the hip is useful in newborns with certain risk factors including breech presentation, firstborn child, family history of DDH, or clinical instability. Treatment depends on several factors, but the most common initial management is the use of a Pavlik harness in newborns. This harness keeps the hip in a position that allows hip stabilization and encourages appropriate joint development. Early treatment is crucial in the development of the hip joint. Treatments other than Pavlik harness include static bracing, operative closed reduction and casting, open reduction and casting, and acetabular or femoral osteotomies. Corrective acetabular or femoral osteotomies require evaluation of the timing and dosage of medications.