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目的探讨婴儿髋关节脱位(CDH)及髋关节发育不良(DDH)的早期X线诊断方法。方法经临床随访证实的26例CDH及DDH婴儿47个患髋和30例正常婴儿60个正常髋关节用X线对照的方法寻求婴儿早期CDH及DDH诊断方法,统计学卡方检验。结果(1)婴儿早期正常髋臼形态为清晰的“一”字形,模糊“一”字形或形态不清应视为异常,敏感度为100%,特异度为91.59%,准确度为85%。统计学比较显示P<0.05;(2)3个月以内婴儿正常髋臼指数应<30°;(3)研究组的47个患髋中闭孔线阳性18髋(其中10髋为CDH),阴性29髋,对照组30例60个正常髋闭孔线阳性2髋,阴性58髋,敏感度为38.3%,特异度为96.7%,准确度为71.1%。统计学比较显示P<0.05;(4)研究组26例47个患髋股骨颈轴线阳性10髋(后均证实为CDH),可疑17髋(后证实13髋为DDH),阴性20髋,对照组30例60个正常髋股骨颈轴线阳性1髋,可疑0髋,阴性59髋,敏感度为57.45%,特异度为98.33%,准确度为80.37%。统计学比较显示P<0.001。结论闭孔线结合股骨颈轴线可诊断新生儿及婴儿早期CDH;髋臼形态异常可提示DDH。
Objective To investigate the early X-ray diagnosis of infant with hip dislocation (CDH) and hip dysplasia (DDH). Methods Totally 26 cases of CDH and 47 DDH infants with hip and 30 normal infants confirmed by clinical follow-up were prospectively investigated by X-ray method for the diagnosis of CDH and DDH in early normal infants. Statistical chi-square test was used. Results (1) The early normal acetabulum of infancy was a clear “one” shape, fuzzy “one” shape or unclear shape should be considered as abnormal, with a sensitivity of 100%, a specificity of 91.59% and an accuracy of 85%. Statistical analysis showed that P <0.05; (2) The normal acetabular index of infants within 3 months should be <30 °; (3) Positive seams were found in 47 of the 47 study groups (18 hips were CDH) Negative 29 hips, control group, 30 cases of 60 normal hip obturator line positive 2 hips, negative 58 hips, the sensitivity was 38.3%, the specificity was 96.7%, the accuracy was 71.1%. Statistical analysis showed that P <0.05. (4) In the study group, 26 patients (47 hips) had posterior femoral neck axis (10 hips after confirmed CDH), 17 hips suspicious (13 hips confirmed DDH), and 20 hips negative The group of 30 normal hip femoral neck axial positive 1 hip, suspicious 0 hips, negative 59 hips, the sensitivity was 57.45%, the specificity was 98.33%, the accuracy was 80.37%. Statistical comparison showed P <0.001. Conclusion Obturator line combined with femoral neck axis can diagnose neonatal and infant early CDH; acetabular abnormalities can be prompted DDH.