von Heideken Johan, Green Daniel W, Burke Stephen W, Sindle Kelly, Denneen John, Haglund-Akerlind Yvonne, Widmann Roger F
Division of Pediatric Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY 10021, USA.
J Pediatr Orthop. 2006 Nov-Dec;26(6):805-8. doi: 10.1097/01.bpo.0000235398.41913.51.
Multiple studies report a correlation between congenital muscular torticollis (CMT) and developmental dysplasia of the hip (DDH) at a rate between 2% and 29%. Most of these studies were completed before the routine use of hip ultrasound. This study assesses the incidence of DDH in a referral population with CMT and the incidence of CMT in a referral population with DDH. We retrospectively reviewed 186 patients referred with a primary diagnosis of DDH and 109 patients referred with a primary diagnosis of CMT between 1995 and 2004. All patients were screened for DDH with ultrasound if they were younger than 4 months and plain radiographs in older children. Among the patients with a primary diagnosis of DDH, 5.9% were subsequently diagnosed with CMT. However, infants who were less than 1 month old when diagnosed with DDH had a 9% risk of subsequent development of CMT. Among the patients primarily diagnosed with CMT, 3.7% were subsequently diagnosed with DDH. Among the patients with DDH, there was a 7.9% coexistence of CMT, regardless of which was diagnosed first, and among the patients with CMT, there was a 12.5% coexistence of DDH. Boys with DDH were 4.97 times more likely than girls to have both DDH and CMT regardless of which diagnosis preceded the other. Our results confirm that patients with CMT should be screened for DDH, and infants, especially boys, treated for DDH should be followed for the development of CMT.
多项研究报告称，先天性肌性斜颈（CMT）与发育性髋关节发育不良（DDH）之间的相关性发生率在2%至29%之间。这些研究大多在髋关节超声常规应用之前完成。本研究评估了CMT转诊人群中DDH的发生率以及DDH转诊人群中CMT的发生率。我们回顾性分析了1995年至2004年间以DDH为主要诊断转诊的186例患者和以CMT为主要诊断转诊的109例患者。所有4个月以下的患者均接受超声DDH筛查，年龄较大的儿童则接受X线平片检查。在以DDH为主要诊断的患者中，5.9%随后被诊断为CMT。然而，诊断为DDH时年龄小于1个月的婴儿，随后发生CMT的风险为9%。在以CMT为主要诊断的患者中，3.7%随后被诊断为DDH。在患有DDH的患者中，无论先诊断出哪种疾病，CMT的共存率为7.9%；在患有CMT的患者中，DDH的共存率为12.5%。患有DDH的男孩同时患有DDH和CMT的可能性是女孩的4.97倍，无论哪种诊断在先。我们的结果证实，CMT患者应接受DDH筛查，而接受DDH治疗的婴儿，尤其是男孩，应随访观察是否发生CMT。
