Wirth T, Haake M, Hahn-Rinn R, Walthers E
Klinik für Orthopädie der Philipps-Universität Marburg.
Z Orthop Ihre Grenzgeb. 1998 May-Jun;136(3):210-4. doi: 10.1055/s-2008-1054224.
In patients with congenital dislocation of the hip the assessment of the correct position of the hip joint after closed or open reduction is very difficult to make from the radiograph with the hips in plaster. As the delayed recognition of a recurrent hip dislocation has bad effects on the outcome of the affected hip a safe and reliable imaging method must be employed.
From 1993 to 1996 6 patients with 8 congenital dislocations of the hip joint were examined by magnetic resonance imaging for evaluation of the position of the hip in plaster after reduction. Magnetic resonance imaging was performed immediately after closed or open reduction. 3 hips had to be treated by open surgery.
The investigation confirmed that magnetic resonance imaging allows perfect differentiation between the bony and cartilaginous parts of the hip joint in plaster as well. Interpositioning of soft tissues which prevent reduction could also be visualized clearly. The best sequence in order to differentiate bony from cartilaginous structures was a gradient echo sequence in flash-technique using a flip-angle of 60 degrees. In all cases the correct position of the hip joint after reduction could be demonstrated in plaster.
Therefore, magnetic resonance imaging is the imaging method of choice for confirmation and documentation of the reduced position of the hip joint in plaster. Radiographs are no longer needed.
对于先天性髋关节脱位患者，在髋关节石膏固定的情况下，很难通过X线片评估髋关节闭合或切开复位后的正确位置。由于复发性髋关节脱位的延迟诊断会对患侧髋关节的预后产生不良影响，因此必须采用一种安全可靠的成像方法。
1993年至1996年，对6例（共8个先天性髋关节脱位）患者进行了磁共振成像检查，以评估复位后髋关节在石膏固定中的位置。在闭合或切开复位后立即进行磁共振成像检查。3个髋关节需要接受开放手术治疗。
研究证实，磁共振成像能够很好地区分石膏固定中髋关节的骨组织和软骨组织。还能清晰显示阻碍复位的软组织嵌入情况。区分骨结构和软骨结构的最佳序列是采用60度翻转角的快速成像梯度回波序列。在所有病例中，均可在石膏固定中显示髋关节复位后的正确位置。
因此，磁共振成像是确认和记录髋关节石膏固定复位位置的首选成像方法。不再需要X线片。
