Baróti Beáta, Pap Zsuzsanna, Pánti Z, Buruian M M, Pávai Z
University of Medicine and Pharmacy of Tirgu Mures, Romania;
Rom J Morphol Embryol. 2013;54(4):977-81.
The main method for the early screening of the developmental dysplasia of the hip (DDH) is the ultrasound imaging. There are several studies about the ultrasound imaging of newborns' hips, but only a few studies include the prenatal period of life. Our aim was to examine the prenatal development of the hip joint through the evolution of the α angle seen on the ultrasound, described in the Graf R method, combined with anatomical dissection.
Thirty-one post-mortem fetal hips were analyzed trough anatomical dissection, in 25 cases trough ultrasound imaging, in which the α angle was measured. Based on the morphometric examination, we applied the sine rule and we calculated the α1 angle, which also represents the coverage of the femoral head.
Based on the morphometric examination, not only the diameters of the femoral head and of the acetabulum, but also the joint cavity (X) showed an increase during development. Both of the α angles (measured α, calculated α1) showed a decrease as the fetus developed.
The decrease of the angles (α, α1) and the increase of the joint cavity during development correspond to the findings of the main research papers: the hip joint is less stable in the perinatal life. The α angle can be accurately determined only after the ossification of the acetabulum had started, in our case after the fetus is older than 18 weeks.
髋关节发育不良(DDH)早期筛查的主要方法是超声成像。关于新生儿髋关节超声成像已有多项研究,但仅有少数研究涵盖了出生前阶段。我们的目的是通过Graf R法中描述的超声α角演变,并结合解剖学解剖,来研究髋关节的产前发育情况。
对31例死胎髋关节进行解剖分析,对其中25例进行超声成像检查并测量α角。基于形态学检查,应用正弦定律并计算α1角,其也代表股骨头的覆盖情况。
基于形态学检查,不仅股骨头和髋臼的直径,而且关节腔(X)在发育过程中均呈现增大。随着胎儿发育,两个α角(测量的α角、计算的α1角)均呈现减小。
发育过程中角度(α、α1)的减小以及关节腔的增大与主要研究论文的结果相符:围产期髋关节稳定性较差。只有在髋臼开始骨化后,在我们的研究中即胎儿超过18周后,才能准确测定α角。