Rühmann O, Konermann W, Lazović D, Vitek L, Bouklas P
Orthopädische Klinik, Medizinischen Hochschule Hannover in Annastift.
Z Orthop Ihre Grenzgeb. 1998 Nov-Dec;136(6):492-500. doi: 10.1055/s-2008-1045176.
Hereditary, pelvic respectively breech presentation or abdominal delivery, premature as well as post-term birth and twin pregnancy are considered to be anamnestic risk factors for congenital dysplasia of the hip. The results of ultrasound hip screening of two University hospitals are presented with special regard to the correlation of these risk factors and the occurrence of pathologic hips.
PATIENTS/METHODS: 24 different physicians of the orthopaedic departments examined the hips of 6617 newborns (female: 3253--49.2%; male: 3364--50.8%) by ultrasound (screening). 94.6% of the examinations were performed within a period of 5 days after birth. The ultrasound examinations, the assessment of the echograms and classification into types of hip were performed according to Graf's technique. All investigations were assessed retrospectively over the period of time with the help of documentation forms (data of newborn baby, case history, clinical and sonographical findings, kind of therapy and procedure) and statistically checked (Chi-Quadrate-test).
In 436 children (6.6%) we found hips required therapy respectively control investigations (type IIa, a < 55 degrees or worse; Graf's classification). For the entire group we achieved the following types of hips (right/left side): Ia--724 (10.9%)/645 (9.8%); Ib--3931 (59.4%)/3892 (58.8%); IIa (> or = 55 degrees)--1733 (26.2%)/1768 (26.7%); IIa (< 55 degrees)--143 (2.2%)/181 (2.7%); IIc--55 (0.8%)/77 (1.2%); D--20 (0.3%)/39 (0.6%); IIIa--9 (0.1%)/11 (0.2%); IIIb--1 (< 0.1%)/3 (0.1%); IV--1 (< 0.1%)/1 (< 0.1%).
In newborn babies with cases of hip dysplasia in their family (heredity) and pelvic respectively breech presentation at birth, as well as for girls and the left side we found a significant higher rate (p < 0.05) of hips required therapy respectively control investigations (type IIa, alpha < 55 degrees or worse; Graf's classification). A correlation of the other mentioned risk factors premature respectively post-term birth, twin pregnancy and cases of abdominal delivery without breech presentation was not evident.
遗传因素、胎位为臀位或剖腹产、早产以及过期产和双胎妊娠被认为是先天性髋关节发育不良的既往危险因素。本文介绍了两家大学医院超声髋关节筛查的结果，特别关注这些危险因素与病理性髋关节发生之间的相关性。
患者/方法：24位不同的骨科医生对6617例新生儿（女性：3253例，占49.2%；男性：3364例，占50.8%）进行了超声髋关节检查（筛查）。94.6%的检查在出生后5天内完成。超声检查、超声图像评估以及髋关节类型分类均按照格拉夫技术进行。借助文档表格（新生儿数据、病史、临床和超声检查结果、治疗类型和程序）对所有调查进行回顾性评估，并进行统计学检验（卡方检验）。
在436例儿童（6.6%）中，我们发现髋关节需要治疗或进行对照检查（IIa型，α<55度或更差；格拉夫分类）。对于整个队列，我们获得了以下髋关节类型（右侧/左侧）：Ia型——724例（10.9%）/645例（9.8%）；Ib型——3931例（59.4%）/3892例（58.8%）；IIa型（≥55度）——1733例（26.2%）/1768例（26.7%）；IIa型（<55度）——143例（2.2%）/181例（2.7%）；IIc型——55例（0.8%）/77例（1.2%）；D型——20例（0.3%）/39例（0.6%）；IIIa型——9例（0.1%）/11例（0.2%）；IIIb型——1例（<0.1%）/3例（0.1%）；IV型——1例（<0.1%）/1例（<0.1%）。
对于家族中有髋关节发育不良病例（遗传）、出生时胎位为臀位或剖腹产的新生儿，以及女孩和左侧髋关节，我们发现需要治疗或进行对照检查（IIa型，α<55度或更差；格拉夫分类）的比例显著更高（p<0.05）。其他提到的危险因素，如早产或过期产、双胎妊娠以及非臀位剖腹产病例之间的相关性并不明显。
