X线摄片及多种超声检查方法在DDH诊治中的联合应用效果

目的 联合应用X线摄片及多种超声检查技术用于评价发育性髋关节发育不良（DDH）诊治的临床效果。方法 回顾性分析2017年9月至2018年9月存在DDH风险因素的婴儿资料共148例296髋，采用Graf法分型，应用Harcke法评价关节稳定性，视分型予以Ottobock支具治疗。对支具治疗无效的病例应用髋人类位石膏固定，应用Novick方法观察头臼对位情况。经治婴儿1岁时复查X线摄片，评价髋关节发育。结果 初诊时按Graf分型Ⅰ型207髋、Ⅱ型76髋、D型3髋、Ⅲ型6髋、Ⅳ型4髋；按Harcke分型稳定248髋、松弛27髋、加压时脱位5髋、可复性脱位13髋、不可复脱位3髋。共治疗81髋，1岁时复查X线摄片发育均在正常范围内。结论 X线摄片联合3种超声方法可全面评价髋关节发育、精准诊断DDH，从而让更多婴幼儿获益。

Combined application effect of X-ray scan and various ultrasound examination techniques in diagnosis and treatment of DDH

Objective The combined application of X-ray photography and various ultrasound examination techniques to evaluate the clinical outcome of developmental dysplasia of the hip (DDH) in early diagnosis and treatment.Methods A retrospective analysis of the data of 296 hips in 148 infants with DDH risk factors from September 2017 to September 2018 was classified by Graf method. Harcke method was applied to evaluate the stabilities of the hips. Ottobock harnesses was used for treatment depending on the classification. Human position spica cast would be given if no efficacy was seen and Novick method was applied to observe the location of femoral head and acetabulum. X-rays were given to the infants underwent treatments when they were above 1 year old and the developments of the hips were evaluated.Results There were 207 type Ⅰ hips, 76 type Ⅱ hips, 3 type D hips, 6 type Ⅲ hips and 4 type Ⅳ hips as Graf classification at first examination. 248 hips were stable, 27 hips were relaxed, 5 hips were dislocated when compressed, 13 hips were reducible and 3 hips were irreducible as Harcke classification. 81 hips were treated in all. All the hips turned to be in normal range at age of 1 year.Conclusion The combination of X-ray scan and three ultrasound tools are effective to comprehensively assess the hip joint and precisely diagnose DDH, which may benefit more infants.