超声评价发育性髋关节脱位婴儿的髋关节生物学特征。

对2013年1月至2016年6月深圳市儿童医院出生1~8个月诊断发育性髋关节脱位的30例患儿进行超声检查，女性25例，男性5例。关节总数60个，脱位关节34个，单侧脱位26例，双侧脱位4例；其中手术治疗20例，非手术治疗10例。全部患儿均经X线、磁共振成像（MRI）检查或手术证实。采用髋关节冠状切面、横切面等进行关节定量超声检测，并行双髋关节X平片测量，比较脱位关节与健侧关节的差异。

脱位关节组患儿α角减小，小于对照关节组患儿[（50.5±3.75）^° vs （64.8±3.38）^°]，且差异有统计学意义（t=-15.181，P<0.001）。脱位关节组患儿骨性髋臼覆盖率减低，股骨头长径减小，股骨头宽径减小，均小于对照关节组患儿[（23.4 ±17.63）% vs （64.3 ±6.45）%，（0.98±0.15）cm vs （1.19±0.11）cm，（1.38 ±0.21）cm vs （1.61 ±0.16）cm]，且差异均有统计学意义（t=-12.469、-6.034、-4.568，P均<0.001）。脱位关节组患儿耻头距、坐头距均增大，均大于对照关节组患儿[（0.97±0.45）cm vs （0.27±0.05）cm，（0.75±0.30）cm vs （0.17±0.05）cm]，且差异均有统计学意义（t=8.805、10.696，P均<0.001）。双侧脱位关节组患儿α角、股骨头长径、股骨头宽径均略小于单侧脱位关节组患儿 [（50.3±2.75）^° vs （51.3±4.77）^°，（0.90 ±0.15）cm vs （0.97 ±0.12）cm，（1.25 ±0.20）cm vs （1.37 ±0.17）cm]，但差异均无统计学意义；而耻头距及坐头距均略大于单侧脱位关节组患儿 [（0.97±0.49）cm vs （0.80±0.31）cm，（0.92±0.26）cm vs （0.68±0.18）cm]，但差异均无统计学意义。超声测量的髋臼指数测值略大于X线片测量的髋臼指数 [（33.13±7.82）° vs （31.20±8.31）°]，但差异无统计学意义。

发育性髋关节脱位患儿髋关节特征包括，骨性髋臼及股骨头发育不良、股骨头与髋臼位置关系异常。对髋关节进行多方位定量超声检测，可定量评估发育性髋关节发育不良（DDH）的结构特征，有助于DDH的早期诊断和随访复查。

To evaluate the biological characteristics of hip joint in infants with developmental dislocation of the hip (DDH).

From January 2013 to June 2016, 30 patients (age from 1 to 8 months, 25 females and 5 males) who were diagnosed as DDH, underwent ultrasound examination in Shenzhen Children′s Hospital, in these patients 20 cases were treated surgically, and 10 cases were treated with non-surgical treatment. There were 34 hips (26 unilateral dislocation and 4 bilateral dislocation) dislocation in 60 hips. All the patients were confirmed by X-ray, magnetic resonance imaging (MRI) examination or operation. All the patients were examined by ultrasound through the coronal and transverse plane of the hip joint. The α angle, femoral head coverage ratio by acetabulum (FHC), femoral head length and width, distance from pubis to femoral head (P-H) and distance from ischium to femoral head (I-H) were measured. The dislocation joints were compared with contralateral joints.

The α angle in the hip dislocation group was smaller than the contralateral group [(50.5±3.75)^° vs (64.8±3.38) ^°], and there was significant difference between the two groups (t=-15.181, P<0.001). The FHC, femoral head length and width in the hip dislocation group were all smaller than the contralateral group [(23.4±17.63)% vs (64.3±6.45)%, (0.98 ±0.15) cm vs (1.19 ±0.11) cm, (1.38±0.21) cm vs (1.61±0.16) cm ], and there were significant differences between the two groups (t= -12.469, -6.034, -4.568, all P<0.001). The P-H and I-H in the hip dislocation group were larger than the contralateral group [(0.97±0.45) cm vs (0.27±0.05) cm, (0.75±0.30) cm vs (0.17±0.05) cm], and there were significant differences between the two groups (t= 8.805, 10.696, both P<0.001). The α angle, femoral head length and width in bilateral dislocation of hip group were slightly smaller than the unilateral dislocation of hip group [(50.3±2.75)^° vs (51.3±4.77)^°, (0.90 ±0.15) cm vs (0.97 ±0.12) cm, (1.25±0.20) cm vs (1.37 ±0.17) cm], but there were no significant differences between the two groups. The P-H and I-H in bilateral dislocation of hip group were slightly larger than the unilateral dislocation of hip group [(0.97±0.49) cm vs (0.80±0.31) cm, (0.92±0.26) cm vs (0.68±0.18) cm], but there were no significant differences between the two groups. The value of acetabular index in the ultrasound group was slightly larger than the X-ray group [(33.13±7.82)^° vs (31.20±8.31)^°], and there were no significant differences between the two groups.

The characteristics of DDH includes acetabulum and femoral head dysplasia, and femoral head and acetabulum position relationship abnormalities. Quantitative ultrasonography of the hip can be used to quantitatively evaluate the structural features of DDH, and it is helpful to the early diagnosis and follow-up of DDH.