发育性髋关节发育不良早期诊断——我们能做什么？

Early diagnosis for developmental dysplasia of the hip：what can we do in China？

对所有新生儿进行超声筛查是实现发育性髋关节发育不良（DDH）早诊断、早治疗、降低并发症的唯一途径。我国是DDH及晚期诊断DDH的高发国家，在未建立全国性的超声筛查体制之前，临床筛查或高危因素的新生儿筛查也是降低晚期诊断DDH发生率的有效方法。我国人口众多，医疗水平发展不平衡，DDH的早期筛查要靠全体社区卫生保健医师、儿科医师、发育儿科医师、甚至产科医师的共同参与。其中，基层卫生保健医师是实现DDH早期筛查的主力军。现阶段，在有条件的地区率先建立区域性的新生儿超声筛查制度势在必行。

Universal ultrasound screening in newborn has been accepted for reducing the incidence of late - detected developmental dysplasia of the hip （DDH）. Unfortunately, the neonatal ultrasound screening strategy has not been applied in the mainland of China, which leads to a high incidence of late -detected DDH. Before implementing the neonatal ultrasound screening strategy, the clinical screening by limited abduction is valid to early diagnose the dislocated hip joint. Additionally,it is necessary to screen all the newborn with high risk factors of DDH, such as positive family history, breech presentation and postnatal hip extended swaddling. Early screening of DDH is the common responsibility of child care doctors, including community health physician, pediatrician or pediatric orthopedist. Currently, it is imperative to build regional neonatal ultrasound screening system for DDH in the regions with tertiary pediatric orthopedic center.