Abstract：
OBJECTIVE: This study aimed to analyze and compare gait patterns and deviations at long-term follow-up in children who received medial open reduction (MOR) before 18 months for unilateral or bilateral hip developmental dysplasia (DDH).
METHODS: A retrospective chart review was conducted on children who underwent MOR. The study population was divided into two groups: the unilateral group, including unilateral (five children with unilateral) and bilateral (five children with bilateral DDH). Ten healthy children were recruited for the control group. Spatiotemporal, kinematic, stiff-knee gait (SKG), and kinetic gait characteristics were analyzed.
RESULTS: Stance time was significantly shorter in both the unilateral (median [IQR]; 590 ms, [560.0-612.5] and bilateral (575 ms, [550-637.5]) groups than in the control group (650, [602.5-677.5]) (p < 0.001), whereas swing time did not differ substantially (p = 0.065) There was no considerable difference in the mean knee flexion at swing between the unilateral (31.6°, [30-36]) and control (30.11°, [27.8-33.6] groups (p > 0.05), but the bilateral group (28.5°, [24.9-32.1]) showed the lower values than the other groups (p < 0.001 for bilateral vs unilateral group; p = 0.008 bilateral vs unilateral group). All the SKG parameters significantly differed among the groups in multi-group comparisons (p < 0.001 for each parameter). Three children had borderline SKG, and two had not-stiff limbs in the unilateral group. In the bilateral group, four children had stiff limbs, and one had borderline SKG. Most kinetic gait parameters were not statistically different between groups (p > 0.05).
CONCLUSIONS: This study has revealed notable deviations in gait patterns of children with DDH treated by MOR at long-term follow-up compared to healthy children\'s gait. MOR could negatively affect pelvic motion during gait due to impaired functions of the iliopsoas and adductor muscles, and SKG can be encountered secondary to iliopsoas weakness.
METHODS: A retrospective chart review was conducted on children who underwent MOR. The study population was divided into two groups: the unilateral group, including unilateral (five children with unilateral) and bilateral (five children with bilateral DDH). Ten healthy children were recruited for the control group. Spatiotemporal, kinematic, stiff-knee gait (SKG), and kinetic gait characteristics were analyzed.
RESULTS: Stance time was significantly shorter in both the unilateral (median [IQR]; 590 ms, [560.0-612.5] and bilateral (575 ms, [550-637.5]) groups than in the control group (650, [602.5-677.5]) (p < 0.001), whereas swing time did not differ substantially (p = 0.065) There was no considerable difference in the mean knee flexion at swing between the unilateral (31.6°, [30-36]) and control (30.11°, [27.8-33.6] groups (p > 0.05), but the bilateral group (28.5°, [24.9-32.1]) showed the lower values than the other groups (p < 0.001 for bilateral vs unilateral group; p = 0.008 bilateral vs unilateral group). All the SKG parameters significantly differed among the groups in multi-group comparisons (p < 0.001 for each parameter). Three children had borderline SKG, and two had not-stiff limbs in the unilateral group. In the bilateral group, four children had stiff limbs, and one had borderline SKG. Most kinetic gait parameters were not statistically different between groups (p > 0.05).
CONCLUSIONS: This study has revealed notable deviations in gait patterns of children with DDH treated by MOR at long-term follow-up compared to healthy children\'s gait. MOR could negatively affect pelvic motion during gait due to impaired functions of the iliopsoas and adductor muscles, and SKG can be encountered secondary to iliopsoas weakness.
摘要：
目的：本研究旨在分析和比较单侧或双侧髋关节发育不良（DDH）18个月前接受内侧切开复位术（MOR）的儿童在长期随访中的步态模式和偏差。
方法：对接受MOR的儿童进行回顾性分析。研究人群分为两组：单侧组，包括单侧(5名儿童单侧)和双侧(5名儿童双侧DDH)。选取10名健康儿童作为对照组。时空,运动学,屈膝步态(SKG),并对动力学步态特征进行了分析。
结果：单侧的站立时间均明显较短（中位数[IQR]；590ms，[560.0-612.5]和双侧（575ms，[550-637.5]）组比对照组（650，[602.5-677.5]）（p<0.001），而摆动时间没有显著差异(p=0.065)[30-36])和控制(30.11°，[27.8-33.6]组（p>0.05），但是双侧组（28.5°，[24.9-32.1]）显示的值低于其他组（双侧vs单侧组p<0.001；双侧vs单侧组p=0.008）。在多组比较中，所有SKG参数在各组之间显着不同（每个参数p<0.001）。三个孩子有临界SKG，单侧组中有两个四肢不僵硬。在双边组中，四个孩子四肢僵硬，其中一个有SKG的边界线。大多数动力学步态参数在组间没有统计学差异(p>0.05)。
结论：这项研究显示，与健康儿童的步态相比，长期随访中接受MOR治疗的DDH患儿的步态模式存在显著差异。由于髂腰肌和内收肌功能受损，MOR可能会对步态过程中的骨盆运动产生负面影响，并且SKG可继发于髂腰肌无力。
方法：对接受MOR的儿童进行回顾性分析。研究人群分为两组：单侧组，包括单侧(5名儿童单侧)和双侧(5名儿童双侧DDH)。选取10名健康儿童作为对照组。时空,运动学,屈膝步态(SKG),并对动力学步态特征进行了分析。
结果：单侧的站立时间均明显较短（中位数[IQR]；590ms，[560.0-612.5]和双侧（575ms，[550-637.5]）组比对照组（650，[602.5-677.5]）（p<0.001），而摆动时间没有显著差异(p=0.065)[30-36])和控制(30.11°，[27.8-33.6]组（p>0.05），但是双侧组（28.5°，[24.9-32.1]）显示的值低于其他组（双侧vs单侧组p<0.001；双侧vs单侧组p=0.008）。在多组比较中，所有SKG参数在各组之间显着不同（每个参数p<0.001）。三个孩子有临界SKG，单侧组中有两个四肢不僵硬。在双边组中，四个孩子四肢僵硬，其中一个有SKG的边界线。大多数动力学步态参数在组间没有统计学差异(p>0.05)。
结论：这项研究显示，与健康儿童的步态相比，长期随访中接受MOR治疗的DDH患儿的步态模式存在显著差异。由于髂腰肌和内收肌功能受损，MOR可能会对步态过程中的骨盆运动产生负面影响，并且SKG可继发于髂腰肌无力。
