Orthopaedics, University-Hospital Waterford, Ireland.
Radiology, Vioapeikonisi Imaging Lab, Heraklion, Greece.
Ultraschall Med. 2019 Aug;40(4):454-464. doi: 10.1055/a-0924-5491. Epub 2019 Jun 13.
In September 2018, an international meeting of doctors of various disciplines, with expertise in the detection and treatment of DDH, was held in Csolyospalos, Hungary. The aim was to achieve consensus on the detection and early treatment of the condition and to develop a standardized system of teaching and training for hip ultrasound. There was strong agreement that US screening is essential. Specifically the Graf technique was selected as the technique of choice. Universal US screening was strongly favored. Screening should be carried out as soon as possible, but not later than the sixth week of age. US screening is cost-effective, does not result in overtreatment, and contributes to a reduction of long-term consequences. The essential principle of treatment is timely application of a device to achieve reduction, retention and maturation, by holding the hips in flexion, and a safe degree of abduction. It was agreed that the effectiveness of any screening policy depends on the correct scanning technique. Therefore, standardization of teaching and training of the Graf technique is mandatory. A unified teaching policy and materials should be developed for this purpose. Certification, re-certification and audit were discussed. The group, which has been formalized as the International Interdisciplinary Consensus Committee On DDH Evaluation (ICODE), will continue to meet and work towards establishing international consensus on DDH, standardizing and developing teaching and training of the Graf technique for hip US, and maintaining standards for detection and management.
2018 年 9 月,在匈牙利的科绍洛什帕洛斯(Csolyospalos)举行了一次多学科医生国际会议,他们在 DDH 的检测和治疗方面拥有专业知识。会议的目的是就该病症的检测和早期治疗达成共识,并制定髋关节超声教学和培训的标准化系统。会议强烈认为,超声筛查是必要的。具体来说,格拉夫(Graf)技术被选为首选技术。普遍赞成进行 US 筛查。筛查应尽快进行,但不迟于出生后 6 周。US 筛查具有成本效益,不会导致过度治疗,并有助于减少长期后果。治疗的基本原则是及时应用器械,通过将髋关节保持在屈曲状态并以安全的外展角度来实现髋关节的复位、保持和成熟。会议还一致认为,任何筛查政策的有效性都取决于正确的扫描技术。因此,必须规范格拉夫技术的教学和培训。为此目的,应制定统一的教学政策和材料。会上还讨论了认证、再认证和审核。该组织已正式成立为国际髋关节发育不良评估多学科共识委员会(ICODE),将继续开会并努力就 DDH 建立国际共识,规范和发展髋关节超声格拉夫技术的教学和培训,并保持检测和管理标准。