Terjesen T, Bredland T, Berg V
Department of Orthopaedic Surgery, Trondheim University Hospital, Norway.
J Bone Joint Surg Br. 1989 Nov;71(5):767-73. doi: 10.1302/0301-620X.71B5.2684989.
The hips of 1000 newborn babies were examined clinically and by ultrasonography. The ultrasound assessment was based on measurements of the coverage of the femoral head by the bony acetabular roof, and this parameter was called the Bony Rim Percentage (BRP). The mean BRP was 55.3% in girls and 57.2% in boys, a significant difference. Clinical instability occurred in 0.7% of the newborn babies, and all of the unstable hips had a BRP below the lower limit of normal. All infants with normal clinical findings and suspected abnormal hips based on ultrasound were followed up; in all but two the hips became normal spontaneously. We conclude that ultrasonography, using the measurements of femoral head coverage, is appropriate for screening the newborn, is reliable in differentiating between a true and a false positive Ortolani sign, and that hip dysplasia which is not clinically demonstrable at birth can be detected by ultrasound. Ultrasound should replace radiography as the routine method of following up high-risk infants and those with suspicious signs.
对1000名新生儿的髋关节进行了临床检查和超声检查。超声评估基于对骨性髋臼顶覆盖股骨头情况的测量，该参数称为骨性边缘百分比（BRP）。女孩的平均BRP为55.3%，男孩为57.2%，差异有统计学意义。0.7%的新生儿出现临床不稳定，所有不稳定髋关节的BRP均低于正常下限。对所有临床检查结果正常但基于超声怀疑髋关节异常的婴儿进行了随访；除两例外，其余婴儿的髋关节均自发恢复正常。我们得出结论，利用股骨头覆盖情况测量的超声检查适用于新生儿筛查，在鉴别真正和假阳性的奥尔托拉尼征方面可靠，且出生时临床无法显示的髋关节发育不良可通过超声检测到。超声应取代X线摄影，作为高危婴儿和有可疑体征婴儿的常规随访方法。
