超声对发育性髋关节异常的评估和治疗随访中的应用价值

The Value of Ultrasound in the Evaluation and Therapy of Developmental Dysplasia of Hip

目的:探讨超声对发育性髋关节异常的评估和治疗随访中的应用价值。方法:对58例临床疑似DDH的患儿共116个髋关节行超声检查,综合运用Graf法、Harcke法以及经腹股沟横切面检查法进行诊断,追踪超声与X线评估髋关节最终发育情况的一致性。结果:根据Graf法及Harcke法示:Ⅰ型68个(58.6%),Ⅱa型14个(12.1%,2个可脱位),Ⅱb型19个(16.4%,12个不稳定,2个可脱位),Ⅱc型6个(5.2%,2个不稳定,3个可脱位),Ⅱd型7个(6.0%,1个不稳定,6个可脱位),Ⅲ型及Ⅳ型共2个(1.7%);经腹股沟横切面检查法:正常髋关节全部在位,48个异常髋关节有43个在位,5个不在位。经治疗后,44个异常髋关节发育好转为Ⅰ型,另有4个终止吊带治疗,择期手术。结论:超声检查可以早期评估儿童髋关节的发育情况,并可作为异常髋关节在治疗中随访监测的常规方法。

Objective:To investigate the value of ultrasound in the evaluation and treatment of development dysplasia of hip.Methods:A total of 116 hip joints of 58 children with clinical suspected DDH were examined by ultrasound.Graf,Harcke and transinguinal sonography method were used for diagnosis to guide the selection of clinical treatment program.Follow-up ultrasound were consistent with X-ray evaluation of the final hip development.Results:According to Graf and Harcke method,68 hips(58.6%)were in type I;type IIa has 14 hips(12.1%,Two are dislocatable),type IIb has 19 hips(16.4%,Twelve are unstable and two are dislocatable),type IIc has 6 hips(5.2%,Two are unstable and three are dislocatable),type IId has 7 hips(6.0%,One is unstable and six are dislocatable),2 hips(1.7%)were in type III and IV.According to transinguinal sonography method,All the normal hips and 43 of the 48 abnormal hips were in place,and 5 were not.44 abnormal hips improved to type I,and 4 ended the sling treatment and underwent elective surgery after treatment.Conclusion:Ultrasound can be used for early assessment of hip development in children and as a routine method for monitoring of abnormal hips during treatment.