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婴儿髋关节发育异常与假性发育异常(作者译)

[Dysplasia and pseudodysplasia of the infantile hip joint (author's transl)].

作者信息

Geiser M

出版信息

Z Orthop Ihre Grenzgeb. 1977 Feb;115(1):1-8.

PMID:842080
Abstract

The natural course of "dysplasia" of the hip diagnosed between the age of two and ten months was followed in 47 children. If the dysplasia diagnosed by radiographs was not combined with a clinical instability of the hip dislocation never occurred although no therapy- except abduction exercise - was given. The radiological signs of dysplasia regularly disappear after the child has learned to walk. Three different kinds of dysplasia are described. Dysplasia may be a residual sign of neonatal instability which became stable with or without treatment. Pseudodysplasia is the effect of faulty X-ray technique or X-ray interpretation. In dysplasia with no known instability in the history it may be the residual sign of a neonatal instability which was not diagnosed or it may be a variation of development of the hip joint during the first year of life. Since dysplasia without clinical instability does not progress and will never end with a dislocation there is no indication for therapeutic measures in a stable hip with radiological signs of dysplasia during the first year of life. The treatment of unstable hips diagnosed between the third and the twelfth month of life may be dangerous due to epiphyseal damage by immobilisation.

摘要

对47名2至10个月大时被诊断为髋关节“发育异常”的儿童进行了随访。如果经X线片诊断的发育异常未合并髋关节临床不稳定,则即使未进行除外展运动之外的任何治疗,髋关节脱位也从未发生。发育异常的放射学征象在儿童学会走路后通常会消失。文中描述了三种不同类型的发育异常。发育异常可能是新生儿期不稳定的残留征象,无论是否接受治疗都已变得稳定。假性发育异常是错误的X线检查技术或X线解读的结果。对于既往无已知不稳定病史的发育异常,它可能是未被诊断出的新生儿期不稳定的残留征象,也可能是髋关节在出生后第一年发育过程中的一种变异。由于无临床不稳定的发育异常不会进展,也永远不会发展为脱位,因此在出生后第一年,对于有发育异常放射学征象的稳定髋关节,没有采取治疗措施的指征。在出生后第3至12个月被诊断为不稳定髋关节的患儿,由于固定可能导致骨骺损伤,其治疗可能存在风险。

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