The Catterall Unit, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
Int Orthop. 2011 Sep;35(9):1359-67. doi: 10.1007/s00264-011-1257-z. Epub 2011 May 7.
Developmental dysplasia of the hip (DDH) is a leading cause of disability in childhood and early adult life. Clinical and sonographic screening programmes have been used to facilitate early detection but the effectiveness of both screening strategies is unproven. This article discusses the role for screening in DDH and provides an evidence-based review for early management of cases detected by such screening programmes.
We performed a literature review using the key words 'hip dysplasia,' 'screening,' 'ultrasound,' and 'treatment.'
The screening method of choice and its effectiveness in DDH still needs to be established although it seems essential that screening tests are performed by trained and competent examiners. There is no level 1 evidence to advise on the role of abduction splinting in DDH although clinicians feel strongly that hip instability does improve with such a treatment regime. The definition of what constitutes a pathological dysplasia and when this requires treatment is also poorly understood.
Further research needs to establish whether early splintage of clinically stable but sonographically dysplastic hips affects future risk of late-presenting dysplasia/dislocation and osteoarthritis. There is a need for high quality studies in the future if these questions are to be answered.
发育性髋关节发育不良（DDH）是儿童和青少年早期残疾的主要原因。临床和超声筛查计划已被用于促进早期发现，但这两种筛查策略的效果尚未得到证实。本文讨论了 DDH 筛查的作用，并为通过此类筛查计划发现的病例的早期管理提供了循证综述。
我们使用关键词“髋关节发育不良”、“筛查”、“超声”和“治疗”进行了文献回顾。
尽管似乎必须由经过培训和有能力的检查者进行筛查测试，但选择何种筛查方法及其在 DDH 中的有效性仍有待确定。虽然临床医生强烈认为髋关节不稳定确实可以通过这种治疗方案得到改善，但对于吊带固定在 DDH 中的作用，尚无 1 级证据可以提供建议。对于什么构成病理性发育不良以及何时需要治疗，也理解得很差。
需要进一步的研究来确定临床上稳定但超声检查显示发育不良的髋关节早期固定是否会影响后期出现发育不良/脱位和骨关节炎的风险。如果要回答这些问题，未来需要高质量的研究。
