Mittelmeier H, Deimel D, Beger B
Orthopädische Universitätsklinik und Poliklinik Homburg/Saar.
Z Orthop Ihre Grenzgeb. 1998 Nov-Dec;136(6):513-8. doi: 10.1055/s-2008-1045179.
Today the hip sonography is an established method to detect congenital hip maturation disturbances in the first days of life. Short-term follow-ups have showed that mature hip joints can be performed with an flexion-abduction bandage within a few months.
This prospective study reviews in a middle-term follow up 57 dysplastic hips at birth of 42 children after an average period of 7.8 years, who took part in an ultrasonic hip screening and were treated successfully with an abduction pant (33 hips type IIg, 16 hips type D, 8 hips type III according to Graf).
There were only 3 cases (5%) who had slight limitations of motion clinically according to the classification of Tönnis. The radiographic control showed an average AC-angle of 11 degree, an average CE-angle of 28 degree and an average hip-score according to Tönnis of 8.5. Slight radiological deviations were found in 9% of the cases. Severe pathologic radiographic appearance or avascular necrosis of the femoral head were not observed.
If DDH is detected in first day of life and immediately treated with abduction pants is physiological development of the hip probably.
如今,髋关节超声检查是检测出生后几天内先天性髋关节发育异常的一种既定方法。短期随访表明,几个月内使用外展屈曲绷带可使髋关节发育成熟。
这项前瞻性研究对42名儿童出生时的57个发育不良髋关节进行了中期随访,平均随访时间为7.8年。这些儿童均参与了髋关节超声筛查,并成功使用外展裤进行了治疗(根据格拉夫分类,33个髋关节为IIg型,16个髋关节为D型,8个髋关节为III型)。
根据托尼斯分类,临床上仅有3例(5%)存在轻微活动受限。X线检查显示平均髋臼角为11度,平均中心边缘角为28度,根据托尼斯标准平均髋关节评分为8.5。9%的病例存在轻微的放射学偏差。未观察到严重的病理X线表现或股骨头缺血性坏死。
如果在出生第一天就检测到发育性髋关节发育不良并立即使用外展裤进行治疗,髋关节可能会正常发育。