Matthiass H H
Klinik für Allgemeine Orthopädie, Westfälischen Wilhelms-Universität Münster/Westf.
Z Orthop Ihre Grenzgeb. 1990 Jul-Aug;128(4):373-6. doi: 10.1055/s-2008-1039881.
Dislocation of the hip associated with cerebral motor disturbances differs considerably from that in children with normal motor activity. In patients with such disturbances ist is a relatively common and often serious complication. It occurs at an age when there are not usually any clear spastic signs, merely hypotonia with reflex-like movement patterns. Early dislocation is marked by early onset of acetabular dysplasia. In the final analysis, hip dislocation associated with cerebral motor disturbances is attributable to a more or less constant muscle imbalance. The prognosis for hip development is poor if there is an early tendency toward flexion and adduction postures and the course of general motor development is unfavorable. The classification proposed by Tönnis and Brunken (1968) is used for radiological assessment. The primary goal of therapy is to prevent further decentration of the hip joint. Therefore, physiotherapy plays the most important role in early treatment of impending dislocation. All other therapeutic measures are secondary to this.
与脑性运动障碍相关的髋关节脱位与运动活动正常的儿童的髋关节脱位有很大不同。在患有此类障碍的患者中，这是一种相对常见且往往较为严重的并发症。它发生在通常没有明显痉挛体征的年龄，仅有肌张力减退和类似反射的运动模式。早期脱位的特点是髋臼发育不良早发。归根结底，与脑性运动障碍相关的髋关节脱位归因于或多或少持续存在的肌肉失衡。如果早期有倾向于屈曲和内收姿势，且总体运动发育进程不利，髋关节发育的预后就很差。采用托尼斯和布伦肯（1968年）提出的分类法进行放射学评估。治疗的主要目标是防止髋关节进一步脱位。因此，物理治疗在早期治疗即将发生的脱位中起着最重要的作用。所有其他治疗措施都次于这一点。
