Graf R
Abteilung für Orthopädie, Allgemeines und Orthopädisches Landeskrankenhaus, Stolzalpe.
Orthopade. 1997 Jan;26(1):33-42. doi: 10.1007/s001320050067.
Therapy for hip dysplasia and DDH by means of sonography. Numerous methods are available for treating "congenital" dysplasia of the hip (CDH). The important point seems to be the differentiation between dysplastic hip joints with and without displaced femoral heads. A historical review of the diagnosis of so-called "congenital dysplasia" and dislocation of the hip and different indications for therapeutic maneuvers is given. Generally, a three-step plan of treatment is recommended: dislocated heads must be reduced, after which retention is needed until the hip joint is stable. This is followed by maturation period, until the nonossified hyalin cartilagenous performed acetabular roof is ossified. All hip joints, regardless of age, can be assigned to one of these phases. In all cases, measures are taken to prevent ischemic necrosis of the femoral head. To prevent the residual dysplasia of the acetabulum roof and femoral head necrosis, the reduction-retention position should be more than 90 degrees flexion in the hip joint, but not more than 45-50 degrees abduction. In each therapeutic phase there is a different biomechanical situation in the hip joint. The appropriate orthosis for treatment is chosen according to the particular biomechanical situation. Each sonographic type can be set up according to the our classification in the three-phase treatment system. In this way the adequate orthosis for treatment in each treatment-phase can be chosen.
超声检查在髋关节发育不良和发育性髋关节脱位治疗中的应用。治疗“先天性”髋关节发育不良（CDH）有多种方法。关键似乎在于区分股骨头有无移位的发育不良髋关节。本文对所谓“先天性发育不良”及髋关节脱位的诊断历史以及治疗手段的不同适应症进行了回顾。一般来说，推荐采用三步治疗方案：首先必须复位脱位的股骨头，之后需要保持复位状态直至髋关节稳定。接着进入成熟期，直到未骨化的透明软骨形成的髋臼顶骨化。所有髋关节，无论年龄大小，都可归入这些阶段之一。在所有情况下，都要采取措施预防股骨头缺血性坏死。为防止髋臼顶残留发育不良和股骨头坏死，复位保持位时髋关节应屈曲超过90度，但外展不超过45 - 50度。在每个治疗阶段，髋关节的生物力学状况各不相同。根据特定的生物力学状况选择合适的治疗矫形器。每种超声类型都可依据我们在三相治疗系统中的分类来确定。这样就能为每个治疗阶段选择合适的治疗矫形器。
