苏州大学医学部儿科临床医学院儿科学 Lesson27.pdfVIP

发育性髋关节脱位 DEVELOPMENTAL DISPLASIA of the HIP (DDH) Department of Pediatrics Soochow University Affiliated Children’s Hospital Can you find any problem in those X-rays ? DEVELOPMENTAL DYSPLASIA OF THE HIP Developmental dysplasia of the hip generally includes subluxation (partial dislocation) of the femoral head, acetabular dysplasia, and complete dislocation of the femoral head from the true acetabulum. Instability Subluxation Dislocation In a newborn, the femoral head can be dislocated and reduced into and out of the true acetabulum. In an older child, the femoral head remains dislocated and secondary changes develop in the femoral head and acetabulum. Incidence The incidence of DDH is approximately 1 in 1000 live births. The left hip is more commonly involved than the right. Bilateral involvement is more common than involvement of the right hip alone. The disorder is more common in females than in males, in many series as much as five times. Several risk factors Several risk factors should arouse suspicion of DDH: 女孩 Female sex 早产 Prematurity 臀位产 Breech delivery 家族史 Family history 神经肌肉系统疾病 Neuromuscular disorders A strong association also exists between DDH and other musculoskeletal, such as : metatarsus adductus congenital torticollis talipes calcaneovalgus 病因学 Etiology Shallow acetabulum Genetic factors Ligament laxity