国际髋关节发育不良学会分型评估股骨头发育延迟的髋关节发育不良儿童的可靠性

Reliability of International Hip Dysplasia Institute classification in evaluating children with developmental dysplasia of the hip combined with delayed femoral head development

目的:比较股骨头发育延迟的髋关节发育不良(developmental dysplasia of the hip,DDH)儿童Tonnis分型和国际髋关节发育不良学会(International Hip Dysplasia Institute,IHDI)分型的一致性,并判断IHDI分型的可靠性。方法:选择2010年1月至2017年1月无锡市儿童医院入选的80例年龄在6~15个月的DDH患者(88髋)的X线片,分别由3名医生对X线片进行Tonnis分型和IHDI分型,使用Kappa法分析不同医生相同分类系统的差异性,判断IHDI分型的可靠性。结果:Tonnis分型和IHDI分型的平均kappa值分别为0.8475和0.9501。加权kappa值也表现出良好的一致性,但IHDI显示更好的一致性(0.9510 vs 0.8554),在无股骨头骨化核一组,IHDI显示出更好的一致性(0.9518 vs 0.8192)。结论:IHDI分型法一致性较Tonnis分型高,对股骨头骨化核发育延迟患儿有较好的实用性。

Objective： To analyze the consistence of Tonnis classification and International Hip Dysplasia Institute （IHDI） classification in Developmental dysplasia of the hip （DDH） children with delayed development of femoral, and determine the reliability of IHDI classification. Methods： From January 2010 to January 2017 in Wuxi Children＇s Hospital Wuxi, a total of 80 cases of 6 months old to 15 months old DDH patients （88 hips） of the X-ray film, respectively, There X-ray films were evaluated by Tonnis classification and IHDI classification by 3 doctors. In order to determine the reliability of IHDI typing classification system, the Kappa method was used to analyze the differences in the same classification system of different doctors. Results： The mean kappa values of Tonnis classification system and IHDI classification system were 0.8475 and 0.9501, respectively. Weighted kappa values also showed good agreement, but IHDI showed better consistency （0.9510 vs 0.8554）; in a group without femoral head ossification, IHDI showed better agreement （0.9518 vs 0.8192）. Conclusion： The IHDI classification system is more consistent than the Tonnis classification, and has a better practicability for the children with delayed ossification of the femoral head.