Chan K G, Galasko C S, Delaney C
Newcastle General Hospital, Newcastle-upon-Tyne, UK.
J Pediatr Orthop B. 2001 Jul;10(3):219-25.
Although hip subluxation and dislocation occur commonly in neuromuscular diseases such as cerebral palsy, spinal muscular atrophy and myelomeningocele, they are not known to commonly affect patients with Duchenne Muscular Dystrophy. In this study, 15 out of 54 patients whose hip radiographs were reviewed showed unilateral subluxation, one had bilateral subluxation and three had unilateral dislocation. Having established that hip subluxation and dislocation develop frequently in patients with Duchenne Muscular Dystrophy, serial hip radiographs should be taken as has been advocated for cerebral palsy. The possible relationship between subluxation and pelvic tilt also calls for better control of sitting posture to prevent pelvic tilt. Spinal stabilization should be carried out at an early age when any scoliosis and pelvic tilt are still mild, so that progressive subluxation of the hip may be delayed or prevented, in addition to maintaining sitting balance and comfort.
尽管髋关节半脱位和脱位在诸如脑瘫、脊髓性肌萎缩症和脊柱裂等神经肌肉疾病中很常见，但在杜氏肌营养不良症患者中并不常见。在本研究中，54例接受髋关节X光片检查的患者中有15例出现单侧半脱位，1例双侧半脱位，3例单侧脱位。既然已经确定髋关节半脱位和脱位在杜氏肌营养不良症患者中经常发生，那么就应该像对脑瘫患者所提倡的那样，定期拍摄髋关节X光片。半脱位与骨盆倾斜之间的可能关系也要求更好地控制坐姿以防止骨盆倾斜。当任何脊柱侧弯和骨盆倾斜仍较轻微时，应在早期进行脊柱稳定治疗，这样除了保持坐姿平衡和舒适度外，还可延缓或防止髋关节进行性半脱位。
