Developmental Dysplasia of the Hip (DDH) describes a wide range of anatomic abnormalities of the growing hips which might result in permanent abnormal gait. Therefore, early detection and management is crucial to impr...Developmental Dysplasia of the Hip (DDH) describes a wide range of anatomic abnormalities of the growing hips which might result in permanent abnormal gait. Therefore, early detection and management is crucial to improve the outcome and minimise the risk of osteoarthritis in later life. Hip ultrasound is used to evaluate DDH based on Graf classification. Graf score is a widely used ultrasound grading score to evaluate DDH in infants. There is conflicting evidence regarding the management of the developmentally immature Graf type IIa hip. Some physicians adopt watchful waiting for natural maturation of hips while other early treatment. This article will provide an evidence-based review on the management modalities of the Graf type IIa hip.展开更多
目的了解宁波市鄞州区新生儿髋关节异常(developmental dysplasia of hip,DDH)发病情况,Ⅱa型DDH高危因素和临床表现,并随访其自然转归。方法使用Mylab50彩色多普勒超声诊断仪于2013年7月-2015年7月对宁波市鄞州第二医院出生新生儿在一...目的了解宁波市鄞州区新生儿髋关节异常(developmental dysplasia of hip,DDH)发病情况,Ⅱa型DDH高危因素和临床表现,并随访其自然转归。方法使用Mylab50彩色多普勒超声诊断仪于2013年7月-2015年7月对宁波市鄞州第二医院出生新生儿在一周内行髋关节超声检查,对其中检查出为Ⅱa型于6~7周龄时免费来院检查,仍异常者予髋关节操和宽尿布法干预到12~14周龄再次复查。并分析Ⅱa型髋关节异常危险因素。结果在行髋关节超声检查2 225例新生儿中,按Graf法分型,发现Ⅱa型392例,Ⅱc型21例,Ⅲ型6例,Ⅳ型4例,初筛阳性率为19.01%(423例)。其中女326例,男97例,女孩发病率为29.74%,男孩的为8.59%,差异有统计学意义(χ2=161.61,P<0.05)。Ⅱa型DDH患儿中仅24例(6.12%)有明显高危因素,17例(4.34%)有临床阳性特征,最常见的高危因素是臀位产,最常见的临床特征是双侧臀纹不对称。Ⅱa型患儿于6~7周和12~14周复查时,大部分自然好转,且男孩比女孩好转率高。结论2013-2015年DDH在宁波市鄞州区新生儿中发病率很高,尤其女孩发病显著高于男孩。Ⅱa型高危因素及临床表现不显著,因此超声筛查尤为重要,对早期诊断和治疗起决定作用。随着生长发育,Ⅱa型大部分可自行好转,但是女孩需要治疗的发生率高于男孩。应当重视对新生女婴的髋关节超声筛查及随访。展开更多
文摘Developmental Dysplasia of the Hip (DDH) describes a wide range of anatomic abnormalities of the growing hips which might result in permanent abnormal gait. Therefore, early detection and management is crucial to improve the outcome and minimise the risk of osteoarthritis in later life. Hip ultrasound is used to evaluate DDH based on Graf classification. Graf score is a widely used ultrasound grading score to evaluate DDH in infants. There is conflicting evidence regarding the management of the developmentally immature Graf type IIa hip. Some physicians adopt watchful waiting for natural maturation of hips while other early treatment. This article will provide an evidence-based review on the management modalities of the Graf type IIa hip.
文摘目的了解宁波市鄞州区新生儿髋关节异常(developmental dysplasia of hip,DDH)发病情况,Ⅱa型DDH高危因素和临床表现,并随访其自然转归。方法使用Mylab50彩色多普勒超声诊断仪于2013年7月-2015年7月对宁波市鄞州第二医院出生新生儿在一周内行髋关节超声检查,对其中检查出为Ⅱa型于6~7周龄时免费来院检查,仍异常者予髋关节操和宽尿布法干预到12~14周龄再次复查。并分析Ⅱa型髋关节异常危险因素。结果在行髋关节超声检查2 225例新生儿中,按Graf法分型,发现Ⅱa型392例,Ⅱc型21例,Ⅲ型6例,Ⅳ型4例,初筛阳性率为19.01%(423例)。其中女326例,男97例,女孩发病率为29.74%,男孩的为8.59%,差异有统计学意义(χ2=161.61,P<0.05)。Ⅱa型DDH患儿中仅24例(6.12%)有明显高危因素,17例(4.34%)有临床阳性特征,最常见的高危因素是臀位产,最常见的临床特征是双侧臀纹不对称。Ⅱa型患儿于6~7周和12~14周复查时,大部分自然好转,且男孩比女孩好转率高。结论2013-2015年DDH在宁波市鄞州区新生儿中发病率很高,尤其女孩发病显著高于男孩。Ⅱa型高危因素及临床表现不显著,因此超声筛查尤为重要,对早期诊断和治疗起决定作用。随着生长发育,Ⅱa型大部分可自行好转,但是女孩需要治疗的发生率高于男孩。应当重视对新生女婴的髋关节超声筛查及随访。
