Objective To summarizethe status of screening of developmental dysplasia of the hip(DDH)in infants and young children 0-36 months of age and to generate a standardized process for DDH screening in infants and young ch...Objective To summarizethe status of screening of developmental dysplasia of the hip(DDH)in infants and young children 0-36 months of age and to generate a standardized process for DDH screening in infants and young children.Methods Preliminary DDH screening was carried out by obstetricians for newborns,and by pediatricians for infants and young children 0-36 months inpatients in ward,and by pediatric surgeon for infants and young children 0-36 months of age outpatient.Secondary screening was performed by pediatric orthopedic surgeons.In addition,ultrasound or radiograph examination of bilateral hip joints was performed.Suspected cases were followed up regularly until patients were diagnosed with DDH or excluded.Results From January2012 to December 2014,22396 infants and young children were screened at the First Affiliated Hospital of Zhengzhou University,Zhengzhou,China.Ultrasound examination was performed for 2669 patients,591 of whom(775 hips)with suspected and abnormal findings were transferred to the Department of Pediatric Orthopedics.Among the referrals,a positive Ortolani or Barlow test was observed in 61 patients(89 hips).Anteroposterior hip radiography showed acetabular dysplasia in 94 cases(131 hips).Finally,76 patients(121 hips)were diagnosed with DDH.Among them,21(29 hips)were males and 55(92 hips)were females.The left side was involved in 91 hips,and the right side was involved in 30 hips.Thirteen cases(including 3 newborns)were 1-6 months old(1.95%,13/6676),49 cases were 7-18 months old(7.09%,49/6909),and 14 cases were 19-36 months old(1.59%o,14/8811).Among the 76 cases of DDH,49(64.47%)were 7-18 months old.The incidence of hip dysplasia was 3.39%(76/22396).Conclusions During the present study,we screened infants and young children 0-36 months old for early detection and diagnosis of DDH and generated a standardized screening process based on the actual status of patients in our district.展开更多
目的总结近期院内0-36个月的新生儿与婴儿髋关节发育不良(developmental dysplasia of the hip,DDH)筛查情况,形成规范的新生儿与婴儿DDH筛查流程。方法我院出生新生儿由产科医师进行DDH的初步筛查,儿内科0-36个月住院患儿及儿外科0-36...目的总结近期院内0-36个月的新生儿与婴儿髋关节发育不良(developmental dysplasia of the hip,DDH)筛查情况,形成规范的新生儿与婴儿DDH筛查流程。方法我院出生新生儿由产科医师进行DDH的初步筛查,儿内科0-36个月住院患儿及儿外科0-36个月的门诊就诊患者分别由儿科医师、儿外科医师进行DDH的初步筛查,可疑或异常者转诊至我院儿童骨科复筛,由儿童骨科医师对转诊儿童再次进行临床检查,并行双髋关节B超或者X线片进一步检查,可疑者定期复查直至确诊或排除。结果2012年1月至2014年12月,共筛查婴幼儿22396例,2699例行髋关节B超筛查,B超检查可疑和异常591例(755髋)转诊到儿童骨科。可疑患儿中61例(89髋)Ortolani或Barlow试验阳性,94例(131髋)骨盆正位X线片显示髋臼发育不良,最终76例(121髋)确诊为DDH。其中男21例(29髋),女55例(92髋);左91髋,右30髋;1-6个月13例(其中新生儿3例)1.95‰(13/6676),7-18个月49例7.09‰(49/6909),19-36个月14例1.59‰(14/8811),76例明确诊断DDH患儿中,7-18个月者49例,占64.47%;DDH的发病率为3.39‰(76/22396)。结论本次筛查对象是0-36个月的新生儿与婴幼儿,这种筛查模式实现了对儿童DDH的早发现、早诊断,形成了符合本地区实际情况的规范筛查流程。展开更多
目的通过对29例成人重度发育性髋关节发育不良（developmental dysplasia of the hip,DDH）患者全髋关节置换术（total hip arthroplasty,THA）中远期疗效的分析,探讨评价THA治疗成人重度DDH的中远期疗效。方法 2007年3月至2011年12月,...目的通过对29例成人重度发育性髋关节发育不良（developmental dysplasia of the hip,DDH）患者全髋关节置换术（total hip arthroplasty,THA）中远期疗效的分析,探讨评价THA治疗成人重度DDH的中远期疗效。方法 2007年3月至2011年12月,于本院骨科收治的29例（32髋）重度DDH患者;年龄为22-57岁,平均43岁。其中左侧18髋,右侧14髋。患髋Harris评分为（41.5±5.3）分。双下肢不等长,患侧短缩2-6 cm,平均4.2 cm,根据Crowe分型标准：III型10例（11髋）,IV型19例（21髋）。患者主要临床症状为患侧髋关节疼痛、活动受限及跛行,部分患者存在腰部疼痛。X线、CT三维重建等辅助检查均显示患髋高度脱位或全脱位。所有患者均由同一主刀医生行人工THA治疗。29例获5-9年随访,平均6.5年。结果患者围手术期无手术短期并发症（血栓、感染、肺炎等）,所有切口均为I期愈合,无髋关节脱位、坐骨神经损伤发生。2例股神经损伤均发生在术后2天,经对症治疗后均治愈。术后患者自述髋关节疼痛症状明显改善或消失,跛行步态比之术前明显好转,生活状态改善。末次随访双下肢长度相差-0.3-1.0 cm,平均0.4 cm。髋关节Harris评分：术后3个月（68.72±5.83）分;术后6个月（77.90±4.63）分;术后1年（86.53±2.65）分;术后2年（87.75±1.82）分;术后3年（87.88±1.59）分;术后4年（88.14±1.26）分;术后5年（88.4±1.1）分。因该组随访资料最短为5年,故采用术后第5年Harris评分与术前（41.5±5.3）分比较,差异有统计学意义（t=6.845,P〈0.001）。复查双髋关节正位X线片可见,髋关节假体位置良好,无感染、骨溶解、松动、脱位现象。随访期间无翻修病例。结论人工THA治疗成人Crowe III-IV型DDH中远期疗效可靠,明显改善患者生存状态。展开更多
基金Provincial Joint Project by the National Health and Family Planning Commission with Henan Province Health and Family Planning Commission(201401007)the Scientific and Technological Key Project by Zhengzhou Science and Technology Bureau(131PPTGG409-23)
文摘Objective To summarizethe status of screening of developmental dysplasia of the hip(DDH)in infants and young children 0-36 months of age and to generate a standardized process for DDH screening in infants and young children.Methods Preliminary DDH screening was carried out by obstetricians for newborns,and by pediatricians for infants and young children 0-36 months inpatients in ward,and by pediatric surgeon for infants and young children 0-36 months of age outpatient.Secondary screening was performed by pediatric orthopedic surgeons.In addition,ultrasound or radiograph examination of bilateral hip joints was performed.Suspected cases were followed up regularly until patients were diagnosed with DDH or excluded.Results From January2012 to December 2014,22396 infants and young children were screened at the First Affiliated Hospital of Zhengzhou University,Zhengzhou,China.Ultrasound examination was performed for 2669 patients,591 of whom(775 hips)with suspected and abnormal findings were transferred to the Department of Pediatric Orthopedics.Among the referrals,a positive Ortolani or Barlow test was observed in 61 patients(89 hips).Anteroposterior hip radiography showed acetabular dysplasia in 94 cases(131 hips).Finally,76 patients(121 hips)were diagnosed with DDH.Among them,21(29 hips)were males and 55(92 hips)were females.The left side was involved in 91 hips,and the right side was involved in 30 hips.Thirteen cases(including 3 newborns)were 1-6 months old(1.95%,13/6676),49 cases were 7-18 months old(7.09%,49/6909),and 14 cases were 19-36 months old(1.59%o,14/8811).Among the 76 cases of DDH,49(64.47%)were 7-18 months old.The incidence of hip dysplasia was 3.39%(76/22396).Conclusions During the present study,we screened infants and young children 0-36 months old for early detection and diagnosis of DDH and generated a standardized screening process based on the actual status of patients in our district.
文摘目的总结近期院内0-36个月的新生儿与婴儿髋关节发育不良(developmental dysplasia of the hip,DDH)筛查情况,形成规范的新生儿与婴儿DDH筛查流程。方法我院出生新生儿由产科医师进行DDH的初步筛查,儿内科0-36个月住院患儿及儿外科0-36个月的门诊就诊患者分别由儿科医师、儿外科医师进行DDH的初步筛查,可疑或异常者转诊至我院儿童骨科复筛,由儿童骨科医师对转诊儿童再次进行临床检查,并行双髋关节B超或者X线片进一步检查,可疑者定期复查直至确诊或排除。结果2012年1月至2014年12月,共筛查婴幼儿22396例,2699例行髋关节B超筛查,B超检查可疑和异常591例(755髋)转诊到儿童骨科。可疑患儿中61例(89髋)Ortolani或Barlow试验阳性,94例(131髋)骨盆正位X线片显示髋臼发育不良,最终76例(121髋)确诊为DDH。其中男21例(29髋),女55例(92髋);左91髋,右30髋;1-6个月13例(其中新生儿3例)1.95‰(13/6676),7-18个月49例7.09‰(49/6909),19-36个月14例1.59‰(14/8811),76例明确诊断DDH患儿中,7-18个月者49例,占64.47%;DDH的发病率为3.39‰(76/22396)。结论本次筛查对象是0-36个月的新生儿与婴幼儿,这种筛查模式实现了对儿童DDH的早发现、早诊断,形成了符合本地区实际情况的规范筛查流程。
文摘目的通过对29例成人重度发育性髋关节发育不良（developmental dysplasia of the hip,DDH）患者全髋关节置换术（total hip arthroplasty,THA）中远期疗效的分析,探讨评价THA治疗成人重度DDH的中远期疗效。方法 2007年3月至2011年12月,于本院骨科收治的29例（32髋）重度DDH患者;年龄为22-57岁,平均43岁。其中左侧18髋,右侧14髋。患髋Harris评分为（41.5±5.3）分。双下肢不等长,患侧短缩2-6 cm,平均4.2 cm,根据Crowe分型标准：III型10例（11髋）,IV型19例（21髋）。患者主要临床症状为患侧髋关节疼痛、活动受限及跛行,部分患者存在腰部疼痛。X线、CT三维重建等辅助检查均显示患髋高度脱位或全脱位。所有患者均由同一主刀医生行人工THA治疗。29例获5-9年随访,平均6.5年。结果患者围手术期无手术短期并发症（血栓、感染、肺炎等）,所有切口均为I期愈合,无髋关节脱位、坐骨神经损伤发生。2例股神经损伤均发生在术后2天,经对症治疗后均治愈。术后患者自述髋关节疼痛症状明显改善或消失,跛行步态比之术前明显好转,生活状态改善。末次随访双下肢长度相差-0.3-1.0 cm,平均0.4 cm。髋关节Harris评分：术后3个月（68.72±5.83）分;术后6个月（77.90±4.63）分;术后1年（86.53±2.65）分;术后2年（87.75±1.82）分;术后3年（87.88±1.59）分;术后4年（88.14±1.26）分;术后5年（88.4±1.1）分。因该组随访资料最短为5年,故采用术后第5年Harris评分与术前（41.5±5.3）分比较,差异有统计学意义（t=6.845,P〈0.001）。复查双髋关节正位X线片可见,髋关节假体位置良好,无感染、骨溶解、松动、脱位现象。随访期间无翻修病例。结论人工THA治疗成人Crowe III-IV型DDH中远期疗效可靠,明显改善患者生存状态。
