Sibiński Marcin, Kozlowski Piotr, Synder Marek
Klinika Ortopedii i Ortopedii Dzieciecej, Uniwersytet Medyczny w Lodzi.
Chir Narzadow Ruchu Ortop Pol. 2005;70(3):173-7.
The purpose of the study was to evaluate the development of the teardrop in children from the time of the initial diagnosis of DDH to skeletal maturity and asses if width, shape and type of teardrop were associated with final results. Anteroposterior pelvis radiographs of sixty eight patients (64 girls and 4 boys) with unilateral dislocation of the hip treated with closed reduction were reviewed retrospectively. The average age of children at the time of initial diagnosis was 13,4 months (range from 5 to 32 months), and at final follow-up minimum 14 years (average 23 years). At the time of initial diagnosis teardrop was seen in 66% normal and 21% dislocated hips. The width of acetabular floor and superior width of teardrop were greater in dislocated hips. Five months after the reduction and at the age of 6 to 8 years teardrop was observed with similar frequency in both groups. In treated hips widening of acetabular floor and superior part of teardrop was still present. The V shape was detected more often in primary dislocated hips at the age of 6 to 8 years and these hips were usually classified as fair or poor according to Severin class at skeletal maturity. There was no relationship between the type of teardrop and the final results. The continued presence of V shaped teardrop, widening of superior width of the teardrop and thickening of the acetabular floor are suggestive of residual dysplasia.
本研究的目的是评估从发育性髋关节发育不良(DDH)初次诊断到骨骼成熟阶段儿童泪滴的发育情况,并评估泪滴的宽度、形状和类型是否与最终结果相关。对68例接受闭合复位治疗的单侧髋关节脱位患者(64例女孩和4例男孩)的骨盆前后位X线片进行回顾性分析。初次诊断时儿童的平均年龄为13.4个月(范围为5至32个月),最终随访时最小年龄为14岁(平均23岁)。初次诊断时,66%的正常髋关节和21%的脱位髋关节可见泪滴。脱位髋关节的髋臼底宽度和泪滴上缘宽度更大。复位后5个月以及6至8岁时,两组中泪滴的观察频率相似。在接受治疗的髋关节中,髋臼底和泪滴上半部分仍有增宽。6至8岁的原发性脱位髋关节中更常检测到V形,根据骨骼成熟时的Severin分级,这些髋关节通常被归类为一般或较差。泪滴类型与最终结果之间没有关系。V形泪滴持续存在、泪滴上缘宽度增宽以及髋臼底增厚提示存在残余发育不良。