摘要
[目的]研究Graf超声检查方法在诊断婴幼儿发育性髋关节异常中的临床价值。[方法]选择2010年8月～2012年9月来本院就诊临床疑似发育性髋关节异常的婴幼儿108例(216个髋关节),其中男婴幼儿35例,女婴幼儿73例;年龄8 d～6个月,平均45 d;依据Graf常规超声检查法,通过测量α、β角度,评估双侧髋关节髋臼形态、股骨头位置,髋臼与股骨头的关系,并对髋关节进行分型。[结果]I型186个(86.1%),Ⅱa型10个(4.9%),Ⅱb型12个(6.0%),Ⅱc型2个(1.1%),Ⅲ型4个(1.9%),IV型2个(1.0%),D型未见。骨顶线夹角α≥60°时,说明髋关节的骨性关节凹发育较好,关节凹较深,股骨头不易脱出关节,骨顶线夹角α﹤60°时,说明髋关节骨性关节凹发育不良,关节凹较浅或较平,股骨头易脱出关节,另外,男婴幼儿髋臼α角度较女婴幼儿大,两者差异有统计学意义(P﹤0.05),提示性别对骨性髋臼发育有影响,双侧比较左侧和右侧髋关节α角右侧较左侧大(P﹤O.05),提示左侧较右侧髋臼发育差。[结论]超声检查法能够早期准确评价婴幼儿髋关节发育情况,并对髋关节发育不良的治疗过程进行随访观察。
[ Objective ] To determine the clinical significance of Graf＇ s ultrasound examination in the diagnosis of pediat- ric developmental dysplasia of the hip. [ Methods] We studied abnormal hips of 108 infants （216 hips; 35 boys, 73 girls; mean age, 45 days [ range, 8 days to 6 months ] ） with suspected developmental hip dysplasia between August 2010 and Septem- ber 2012. Graf＇s conventional ultrasonography examination was used to measure angles a and b to evaluate coronal acetabular form and femoral head position in both hips. For analysis, hips were classified according to the related risk factors. [ Results] According to Graf＇s ultrasound classification, the hips were classified as follows ： type Ⅰ, 186 （86. 1% ） ; type Ⅱα, 10 （4. 9% ） ; typeⅡb, 12 （6.0%）; typeⅡc, 2 （1.1%）; typeⅢ, 4 （1.9%）; and type Ⅳ,2 （1.0%） . Type D was not seen. Anglea = 60° was representative of hip joint osteoarthritis, good concave growth, concave and deep joint socket, and a femoral head that was not easily dislocated. Angle α 〈 60° was representative of hip joint osteoarthritis, concave dysplasia, relatively shallow or flat joint socket, and a femoral head that was easily dislocated. There was a statistical significant difference in the acetabular angle between boys and girls （ P 〈 0. 05 ） . Therefore, sex had an influence on osseous aeetabular development. A comparison of left and right hips showed that the right a angle was correlated with the left （P 〈 0. 05） . [ Conclusion ] Ultrasonography can be used to accurately evaluate developmental hip dysplasia in children and can contribute to early diagnosis and effective treat-ment.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2013年第11期1065-1068,共4页
Orthopedic Journal of China
基金
内蒙古自然科学基金资助项目(编号:2012MS1186)
内蒙古自治区高等学校科学研究项目(编号:NJZC12161)
