| Objective To discuss early diagnosis and curative effect evaluation of developmental dysplasia of hip in infants with high-frequency ultrasonography,to research on Developmental Displasia of the Hip in neonatals of different regions,and to determine whether there are differences among different regions and ethnic,and to study the related factors to provide the basis for early diagnosis and treatment of DDH.Part one Early diagnosis and curative effect evaluation of developmental dysplasia of hip in infants with high-frequency ultrasonographyMethods 109 cases with single / double-sided 116 hips among 1074 infants who was suspected developmental dysplasia,are diagnosed by ultrasound according to Graf classification,to re-examined after non-intervention or Pavlik harness treatment and evaluate hip development state and comparison of the two measurements using statistic.Results(1)109 infants diagnosed first by ultrasound showed: 102 hips(46.8%)were type?,83hips(38.1%)were type?a and ?b,12 hips(5.5%)were type?c,9 hips(4.1%)were type D,9hips(4.1%)were type ?,3 hips(1.4%)were type ?;(2)Re-examined by ultrasound showed: 64 hips into type?among type?a and ?b which diagnosed first but have no clinical intervention;hips of type?c,type D and type ? were re-examined after treated with Pavlik harness,15 of them were in type?,9 hips were in type II b,6 hips were in type IIc,2 hips were in type D.(3)Comparison with twice angle ? of ?a and ?b showed they had statistically significant,P=0.026,P=0.043,while the angle ? was not significantly different;the angle ? and ? of rest hips type were not statistically significant.Part two Comparative study on Developmental Displasia of the Hip and relevant differences in neonatal of different regionsMethods 544 hips of 272 infants were examined with ultrasound,to evaluate the hip dysplasia by Graf's method and to compare the incidence of Developmental Displasia of the Hip in neonatals of different regions,and analysis relevant parameters(angle ?,angle ?,femoral head percentage of cover,acetabular index,L parameter).Results(1)The positive rate of 544 hips show as follow:type ?were 502,accounting for92.3%;type?were 42,accounting for 7.7%,of which 8.0%(22/272)were in Lanzhou,10.7%(29/272)were in Karamay,and 10.3%(14/136)were the Hui nationality,13.2%(18/136)were Uighurs;(2)Comparison between the relevant parameters:there have significance among the angle ?,AI between different regions,P=0.025 and P=0.017,respectively,but angle ?,FHC% and L value have no significance;there were significance among the angle ?,AI,L values between different regions,P=0.030,P=0.020 and P=0.048,respectively,but same nation,and angle ?,FHC%were no meaning.And for four groups,there also have significance among the angle ?,AI between different regions,P=0.046 and P=0.031,respectively,but angle ?,FHC% and L value have no significance.Part three Ultrasound in the diagnosis of DDH and analysis the related factors of infantMethods 1674 infants who less than 6 months of three ethnic groups(the han,hui,Uighur),checked bilateral hip by clinical examination(watch hip external morphological,developmental situation and motions),and ultrasound screening,analyzed the positive rate of both means in the diagnosis of DDH.And review the related information with DDH when infant was born such as gender,national,delivery methods,presentation,amniotic fluid volume,birth order,gestational age,first visit,maternal age,etc,to study the correlation of the factors and DDH.Results(1)There had significant difference between the methods of clinical and ultrasound.and also of left and right DDH in infants(c2=40.916,p=0.00)and the male and female(c2=37.583,p=0.00).(2)The multiple factors analysis showed that there were a positive correlation between DDH and the gender,side,amniotic fluid volume,gestational age,first visit age,maternal age,birth weight,delivery methods,and there were a negative correlation between DDH and delivery methods and presentation,however,there were no correlation between DDH and national and birth order.Conclusion(1)High frequency ultrasound can dynamically observe developmental dysplasia of hip in infants,and provide a reliable basis for assessing the clinical efficacy;(2)There have difference of DDH parameter(angle ?,AI)in different regions and ethnic,but angle ?,FHC% and L value have no significance;Early screening can provide a guidance for DDH treatment of clinical;(3)High frequency ultrasound is better than clinical examination in early diagnosis of DDH(within 6 months after birth);there were a correlation between DDH and the gender, side,amniotic fluid volume,gestational age,first visit age,maternal age,birth weight,delivery methods,delivery methods and presentation. |
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