DISLOCATION OF THE HIP IN CEREBRAL-PALSY - NATURAL-HISTORY AND PREDICTABILITY
DISLOCATION OF THE HIP IN CEREBRAL-PALSY - NATURAL-HISTORY AND PREDICTABILITY
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DOI：
10.1302/0301-620x.71b3.2722938
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发表时间：
1989-05-01
影响因子：
--
通讯作者：
CAREY, RPL
中科院分区：
文献类型：
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作者：
COOKE, PH;COLE, WG;CAREY, RPL
为了解脑性瘫痪髋关节脱位的自然病程，并发展预测脱位的方法，对452例脑性瘫痪患者的髋关节记录和X线片进行了回顾性分析。在髋臼发育不良的情况下，10%的患者发生了股骨近端进行性移位和半脱位。统计分析确定了有助于预测脱位的影像学特征。通过髋臼旋转的方法测量髋臼指数是最有效的单一预测因子。在2岁和4岁时测量该指数可以识别出除非进行有效治疗否则会脱位的患者，只有在脊柱侧凸发展时才有脱位风险的患者，以及不会脱位的患者。在此基础上，提出了一种合理的脱位预防手术方法。
To determine the natural history of dislocation of the hip in cerebral palsy, and to evolve methods to predict dislocation, the noted and radiographs of 452 patients with cerebral palsy were reviewed. Dislocation occurred in 10% of patients by progressive migration and subluxation of the proximal femur in the presence of acetabular dysplasia. Statistical analysis identified the radiographic features that helped to predict dislocation. Measurement of acetabular index, by a method that allows for rotation of the acetabulum, was the most powerful single predictor. Measurement of this index at two and four years of age could identify patients who would dislocate unless effective treatment was undertaken, those at risk of dislocation only if scoliosis developed, and those who would not dislocate. On the basis of this method of screening for dislocation, a logical system of surgical prophylaxis is proposed.