Synder Marek, Niedzielski Kryspin, Grzegorzewski Andrzej
Klinika Ortopedii i Ortopedii Dzieciecej, Uniwersytet Medyczny, Łódź
Ortop Traumatol Rehabil. 2003 Dec 30;5(6):717-21.
Background. Ultrasound of the newborn hip is now a standard procedure in the diagnosis of developmental dysplasia of the hip (DDH). Together with clinical examination give us full information about the newborn hip.
Material and methods. In the Clinic of Orthopaedics Medical University of Lodz the ultrasound examination of the newborn hips begun in 1983 and about 2500 examination are performed each year. The own material consisted of 35 000 newborns hips examined because of DDH. During the examination special attention was payed to the risk factors of the DDH. As a standard the ultrasound examination was performed in the first week of the life and at the age of 4 months. The linear transducer of 7.5 MHz in newborns and 5 MHz in neonate hip was used.
Results. The signs of dysplasia were found in 5,6% of all examined hips. The most frequent type of dysplasia was type II according to Graf classification - 75% of all dysplastic hips. Type IIc was diagnosed in 5%. Dysplasia types with decentration was recognized in 20% dysplastic hips. The treatment differed from type of dysplasia and the age of the child. In the treatment diapers, Freyka pillow, Pavlik splint were used. The overhead traction and surgical treatment was used in selected cases. The time of the rebuilding of the dysplastic hip depended on the type of dysplastic hip and for the type IIa - 4-6 weeks, for type IIc and d from 6 do 12 weeks, for type IIIa - 8-14 weeks, type IIIb - 13-16 weeks, and for type IV - 12 do 24 weeks. In 5% of all examined hips surgery was recommended.
Conclusions. The ultrasound examination of the newborns hips is a standard procedure in diagnosis and monitoring of treatment of DDH. The examination should be performed in the first weeks of life. Further cooperation between orthopaedic surgeons and pediatrician is necessary.
背景。新生儿髋关节超声检查现已成为诊断发育性髋关节发育不良（DDH）的标准程序。它与临床检查一起为我们提供了有关新生儿髋关节的全面信息。
材料与方法。罗兹医科大学骨科诊所于1983年开始对新生儿髋关节进行超声检查，每年约进行2500次检查。我们自己的材料包括因DDH接受检查的35000例新生儿髋关节。检查期间特别关注DDH的危险因素。作为标准，超声检查在出生后第一周和4个月龄时进行。新生儿使用7.5MHz的线性探头，新生儿髋关节使用5MHz的探头。
结果。在所有检查的髋关节中，5.6%发现发育异常迹象。根据Graf分类，最常见的发育异常类型是II型——占所有发育异常髋关节的75%。IIc型诊断为5%。20%的发育异常髋关节存在脱位型发育异常。治疗方法因发育异常类型和患儿年龄而异。治疗中使用了尿布、Freyka枕、Pavlik吊带。在某些情况下使用了头高位牵引和手术治疗。发育异常髋关节的重建时间取决于发育异常髋关节的类型，IIa型为4至6周，IIc型和d型为6至12周，IIIa型为8至14周，IIIb型为13至16周，IV型为12至24周。在所有检查的髋关节中，5%建议进行手术。
结论。新生儿髋关节超声检查是DDH诊断和治疗监测的标准程序。该检查应在出生后的头几周内进行。骨科医生和儿科医生之间需要进一步合作。
