Ortolani 试验在临床髋关节发育不良筛查中具有较高的阳性预测值。

The Ortolani test has a high positive predictive value in clinical hip screening for developmental dysplasia of the hip.

机构信息

Department of Surgery, Oulu University Hospital, Oulu, Finland.

Medical Research Center Oulu, University of Oulu, Oulu, Finland.

出版信息

Acta Paediatr. 2023 Jul;112(7):1586-1591. doi: 10.1111/apa.16757. Epub 2023 Mar 25.

DOI:10.1111/apa.16757

PMID:36928888

Abstract

AIM

Previous studies have not described separate positive predictive values for Ortolani and Barlow tests in clinical hip screening. We aimed to determine the positive predictive values at discharge following birth, in predicting dysplasia or instability in the subsequent hip ultrasound examinations.

METHODS

We included all infants with suspected or diagnosed DDH at the study hospital from 2015 to 2017 in this retrospective study. Infants with positive Ortolani or Barlow test after birth were referred for a hip ultrasound, without treatment being started. The positive predictive value of the tests to predict Graf type ≥ IIC morphology, ≥5 mm displacement in a dynamic ultrasound, or either one or both findings at the hip ultrasound examination was calculated.

RESULTS

There were 33 Ortolani-positive hips and 103 Barlow-positive hips in 105 referred infants (30% male) at the screening. They received ultrasound examination at mean 21.7 days of age (SD 4.8, range 11-35). The positive predictive value was 39-61% for the Ortolani test and 4%-16% for the Barlow test depending on the true positive definition.

CONCLUSION

The Ortolani test, performed by a specialist at the maternity ward, has a high positive predictive value for developmental dysplasia of the hip.

摘要

目的

既往研究尚未描述临床髋关节筛查中 Ortolani 试验和 Barlow 试验的单独阳性预测值。本研究旨在确定出生后出院时的阳性预测值，以预测随后髋关节超声检查中的发育性髋关节发育不良或不稳定。

方法

本回顾性研究纳入了 2015 年至 2017 年在研究医院中疑似或诊断为发育性髋关节发育不良的所有婴儿。出生后 Ortolani 或 Barlow 试验阳性的婴儿被转诊进行髋关节超声检查，但未开始治疗。计算这些试验预测 Graf 分型≥IIC 形态、动态超声中≥5mm 移位或髋关节超声检查中任何一种或两种表现的阳性预测值。

结果

在 105 例转诊婴儿（30%为男性）中，有 33 例 Ortolani 试验阳性和 103 例 Barlow 试验阳性。他们在平均 21.7 天（标准差 4.8，范围 11-35）龄接受超声检查。根据真正阳性的定义，Ortolani 试验的阳性预测值为 39%-61%，Barlow 试验的阳性预测值为 4%-16%。