髋关节发育不良风险因素的发生率:对 18954 个病例的回顾性研究。

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-09-01 Epub Date: 2024-05-20 DOI:10.1177/11207000241248416
Gaetano Caruso, Edoardo Gambuti, Elisa Spadoni, Sara Filipponi, Achille Saracco, Francesca Artioli, Ambra Galla, Leo Massari
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引用次数: 0

摘要

背景:DDH 是导致儿童残疾的最重要原因之一。新生儿期可通过奥托拉尼(Ortolani)和巴洛(Barlow)手法诊断出DDH不稳定。然而,临床检查虽然特异性很高,但与超声检查相比灵敏度较低。对于是否有必要对所有新生儿进行发育不良的普遍筛查,还是对有不稳定性临床表现或已知 DDH 危险因素的新生儿进行选择性筛查,目前还存在争议:这是一项横断面研究,对象是2000年1月至2019年12月期间在意大利费拉拉马里诺-奥托拉尼中心连续接受检查的婴儿。格拉夫分类法的前3种类型被认为是生理性的(1A、1B、2A+),而后6种是病理性的(2A-、2B、2C、2D、3、4):18954 名婴儿符合纳入标准,因此被认为符合研究条件。在这 18954 名婴儿中,56%(n = 10629)为女性,44%(n = 8325)为男性。根据格拉夫分类,34.9%(n = 6621)为 1A,52.7%(n = 9999)为 1B,4.0%(n = 753)为 2A+,2.5%(n = 478)为 2A-,1.5%(n = 284)为 2B,1%(n = 196)为 2C,1.3%(n = 243)为 2D,1%(n = 193)为 3,1.0%(n = 187)为 4。最重要的风险因素是女性(OR 5.36;95% CI,4.63-6.20),其次是家族史(OR 2.35;95% CI,2.08-2.65),然后是骨骼病变(OR 2.04;95% CI,1.21-3.42)、少水胎儿(OR 1.75;95% CI,1.44-2.13),最后是臀先露(OR 1.42:95% CI,1.27-1.60):根据我们的数据,家族史、肌肉骨骼疾病、少水胎儿和臀先露是导致 DDH 的主要风险因素,女性也是风险因素之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidence of risk factors in developmental dysplasia of the hip: a retrospective study on 18,954 cases.

Background: DDH is 1 of the most important causes of childhood disability. A diagnosis of instability can be made in the neonatal period via the Ortolani and Barlow manoeuvres. However, clinical examination, although highly specific, has poor sensitivity as compared to ultrasound. There is controversy between the necessity of universal screening for dysplasia of all newborns or selective screening reserved for those with clinical signs of instability or known risk factors of DDH.

Aim: To analyse the risk factors of congenital hip dysplasia in a consecutive case series of children referred for diagnosis and treatment of DDH.

Materials and methods: This was a cross-sectional study on infants consecutively examined between January 2000 and December 2019 at the Marino Ortolani Centre in Ferrara, Italy. The first 3 types on Graf's classification were considered physiological (1A, 1B, 2A+), while the last 6 pathological (2A-, 2B, 2C, 2D, 3, 4).

Results: 18,954 infants met the inclusion criteria and were therefore considered eligible for the study. Of these 18,954 infants, 56% (n = 10,629) were females and 44% (n = 8325) were males. According to Graf classification, 34.9% (n = 6621) were 1A, 52.7% (n = 9999) were 1B, 4.0% (n = 753) were 2A+, 2.5% (n = 478) were 2A-, 1.5% (n = 284) were 2B, 1% (n = 196) were 2C, 1.3% (n = 243) were 2D, 1% (n = 193) were 3 and 1.0% (n = 187) were 4. The most significant risk factor was the female gender (OR 5.36; 95% CI, 4.63-6.20) followed by a family history (OR 2.35; 95% CI, 2.08-2.65), then skeletal pathologies (OR 2.04; 95% CI, 1.21-3.42), oligohydramnios (OR 1.75; 95% CI, 1.44-2.13), and finally breech presentation (OR 1.42: 95% CI, 1.27-1.60).

Conclusions: Based on our data, family history, musculoskeletal disease, oligohydramnios and breech presentation are the main risk factors for DDH development, as is the female sex.

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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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