Abstract:

Objective　To evaluate the clinical value of combined Graf and Harcke ultrasonography in early diagnosis and therapeutic effect evaluation of infant developmental dysplasia of the hip (DDH). Methods　The clinical data of 120 children (240 hips) with high risk of DDH within 6 month-old of age in Children's Hospital Affiliated to Zhengzhou University from January 2017 to February 2023 were collected. There were 54 boys and 66 girls, aged 1 to 6 (2.53±0.68) months. Graf and Harcke methods were used to evaluate the development and stability of hip joint. X-ray reexamination was performed for the treated children after 1 year-old of age, and the DDH treatment effect was evaluated by the International Hip Dysplasia Institute (IHDI) classification. Results　A total of 24 hip joints (10.00%, 24/240) were found to be suspicious abnormal in the first ultrasound examination, and all of them returned to normal after 4 - 6 weeks. There were 76 abnormal hips [31.67% (76/240)], among which 12 hips were "unstable" with Graf Ⅰ type and 4 hips with Graf Ⅱa type. After 4 - 6 weeks, 14 cases returned to normal but 2 cases turned to Graf Ⅱb type and received surgical treatment. There were 43 hip joints with dysplasia and 17 hip joints with dislocation, which were treated with surgical intervention. All the treated 62 hips after 1 year-old of age turned to IHDI Ⅰ type by X-ray review, with a acetabular index of (25±2)°. Conclusion　The combined application of Graf and Harcke techniques to observe hip joint from static and dynamic angles, respectively, has high clinical value in screening DDH and evaluating the therapeutic effect.

Key words:

Ultrasonography, Development dysplasia of the hip, Graf, Harcke, Infants

摘要：

目的　分析联合应用Graf和Harcke超声检查技术对婴幼儿发育性髋关节发育不良（DDH）早期诊断和疗效评估的临床价值。方法　收集2017年1月至2023年2月郑州大学附属儿童医院6月龄以内具有DDH高危风险的120例（240髋）患儿临床资料，其中男54例，女66例，月龄1～6（2.53±0.68）个月。联合应用Graf法和Harcke法评估髋关节发育情况和稳定性，对经过治疗的患儿1岁后进行X线复查，应用国际髋关节发育不良协会（IHDI）分型评估DDH治疗效果。结果　超声首次检查共发现可疑异常髋关节24髋，占10.00%（24/240），4～6周后复查均转为正常髋关节。异常髋关节76髋，占31.67%（76/240），其中Graf Ⅰ型“不稳定”12髋，Graf Ⅱa“不稳定”4髋，4～6周后复查14例转为正常，2例转为Graf Ⅱb型而给予外科治疗；发育不良髋关节43例，脱位髋关节17例，均接受外科干预治疗。1岁后，接受治疗的62髋进行X线复查均转为IHDI Ⅰ型，髋臼指数为（25±2）°。结论　Graf法和Harcke法分别从静态和动态不同角度观察髋关节，二者联合应用，在全面筛查DDH和评估治疗效果中具有较高的临床价值。

关键词:

超声检查, 发育性髋关节发育不良, Graf法, Harcke法, 婴幼儿