Holen K J, Terjesen T, Tegnander A, Bredland T, Saether O D, Eik-Nes S H
Department of Orthopaedics, Trondheim University Hospital, Trondheim, Norway.
J Pediatr Orthop. 1994 Sep-Oct;14(5):667-73. doi: 10.1097/01241398-199409000-00022.
We evaluated risk factors for neonatal hip instability (NHI) at birth using ultrasonography and assessed the reliability of our ultrasound method by means of an interobserver study. The hips of 4,459 newborns were examined by ultrasound from 1988 to 1990. The ultrasound evaluation was based mainly on measurement of femoral head coverage (FHC) by the bony acetabular roof. The mean FHC was 56% in boys and 54% in girls (a significant difference). Fifty-five newborns with unstable hips had a mean FHC of 37%, which was significantly lower than that of the normal hips. Known risk factors for NHI were confirmed (breech position, family history of hip dysplasia, increased birth weight), but no new risk factors were detected. The interobserver study included 200 hips. The 95% confidence limit for interobserver variation in FHC (+/- 2 SD) was +/- 8%. Because of this moderate interobserver variation, and because the incidence of late-detected hip dysplasia was low (0.2 per 1,000), we conclude that our method for ultrasound examination is sufficiently reliable for screening of hips in newborns.
我们使用超声评估了新生儿出生时髋关节不稳定（NHI）的风险因素，并通过观察者间研究评估了我们超声方法的可靠性。1988年至1990年期间，对4459名新生儿的髋关节进行了超声检查。超声评估主要基于骨性髋臼顶对股骨头覆盖度（FHC）的测量。男孩的平均FHC为56%，女孩为54%（差异显著）。55名髋关节不稳定的新生儿平均FHC为37%，明显低于正常髋关节。已确认的NHI风险因素（臀位、髋关节发育不良家族史、出生体重增加）得到证实，但未发现新的风险因素。观察者间研究包括200个髋关节。FHC观察者间变异的95%置信区间（±2 SD）为±8%。由于观察者间变异适中，且晚期发现的髋关节发育不良发生率较低（每1000例中有0.2例），我们得出结论，我们的超声检查方法对于新生儿髋关节筛查具有足够的可靠性。
