Ilfeld F W, Westin G W, Makin M
Clin Orthop Relat Res. 1986 Feb(203):276-81.
In 15 documented cases, subluxation or dislocation of the hip was discovered months or years after previous multiple normal physical examinations. The examiners were unique in that six were professors specializing in childrens' orthopedics, four were board-certified orthopedists, and five were pediatricians. An increased acetabular index, subluxation, and early dislocation may not always be detected on physical examination. Delayed diagnosis of dislocation is not evidence that an inadequate physical examination was performed. An increased acetabular index may allow the femoral head to move laterally out of the acetabulum and become a delayed dislocation. The delayed subluxed or dislocated hip constitutes an entity not necessarily related to the neonatal subluxable or dislocatable hip.
在15例有记录的病例中，髋关节半脱位或脱位是在之前多次体格检查均正常数月或数年之后才被发现的。检查者阵容强大，其中6位是儿童骨科教授，4位是获得委员会认证的骨科医生，5位是儿科医生。髋臼指数增加、半脱位及早期脱位在体格检查时不一定总能被发现。脱位的延迟诊断并不证明体格检查不充分。髋臼指数增加可能会使股骨头向髋臼外侧移位并导致延迟性脱位。延迟性半脱位或脱位的髋关节是一种不一定与新生儿可半脱位或可脱位髋关节相关的情况。
