Tönnis D
Orthopädische Klinik, Städtische Kliniken Dortmund.
Orthopade. 1997 Jan;26(1):49-58. doi: 10.1007/s001320050069.
Radiographic examination of infants' hips is still indicated sometimes in addition to the sonographic examination. The legs have to be kept in a neutral position. The pelvis should not be turned to the side or tilted. Hilgenreiner's acetabular index is preferred in the diagnosis of hip dysplasia. Long-term follow-ups of critical values show spontaneous improvement in some cases, but also joints with increasing dysplasia. Critical values between one and two standard deviations of our material and somewhat above have to be followed. The axial orthograde view of the hip as a lateral view of the femoral head is recommended in Perthes' disease to determine the Catterall groups more exactly than in the Lauenstein position. Arthrography is still indicated in dislocated hips that cannot be reduced into the socket because of a narrow cartilaginous inlet. Here the risk of avascular necrosis is high and traction is indicated.
除超声检查外，婴儿髋关节的X线检查有时仍有必要。双腿必须保持中立位。骨盆不应向一侧旋转或倾斜。在髋关节发育不良的诊断中，希尔根赖纳髋臼指数更受青睐。对临界值的长期随访表明，某些情况下会自发改善，但也有发育不良加重的关节。必须遵循我们的数据中一到两个标准差之间及略高于此的临界值。在佩特兹病中，推荐采用髋关节的轴向正位片作为股骨头的侧位片，以比劳恩施泰因位更准确地确定卡特拉尔分组。对于因软骨入口狭窄而无法复位入髋臼的脱位髋关节，关节造影仍有必要。此处发生缺血性坏死的风险很高，需要进行牵引。
