CAJ | 학술논문

目的：通过回顾 Graf Ⅱa 型髋关节异常婴儿的髋关节发育情况，分析其与高危因素、伴发畸形和髋关节稳定性等的关系，初步探讨其与髋关节发育不良的关系。方法回顾性分析2012年1月至2013年6月疑似髋关节异常的筛查病例5816例，均采用标准化髋关节超声波检查，统计 Graf Ⅱa型髋关节异常的发生率和髋关节发育的恶化率，评估其与髋关节异常的高危因素、伴发畸形、髋关节稳定性、侧别和性别的关系。结果筛查发现 Graf Ⅱa 型髋关节异常有112例（6．4％），172髋，平均随访10周后超声检查髋关节发育恶化病例为19例（18．6％），24髋，其中 Graf Ⅱb 型为14例，18髋；Ⅱc型为2例，3髋；D 型为2例，2髋；Ⅲ型为1例，1髋。统计发现存在伴发畸形和单侧 Graf Ⅱa 型髋关节异常病例有更高的髋关节发育不良发生率。结论Graf Ⅱa 型髋关节异常病例中，18．6％的病例有髋关节发育不良的可能，临床需密切随访观察，尤其是有伴发畸形和单侧发病的病例，但与临床隐匿性髋关节发育不良的关系有待进一步研究。
목적：통과회고 Graf Ⅱa 형관관절이상영인적관관절발육정황，분석기여고위인소、반발기형화관관절은정성등적관계，초보탐토기여관관절발육불량적관계。방법회고성분석2012년1월지2013년6월의사관관절이상적사사병례5816례，균채용표준화관관절초성파검사，통계 Graf Ⅱa형관관절이상적발생솔화관관절발육적악화솔，평고기여관관절이상적고위인소、반발기형、관관절은정성、측별화성별적관계。결과사사발현 Graf Ⅱa 형관관절이상유112례（6．4％），172관，평균수방10주후초성검사관관절발육악화병례위19례（18．6％），24관，기중 Graf Ⅱb 형위14례，18관；Ⅱc형위2례，3관；D 형위2례，2관；Ⅲ형위1례，1관。통계발현존재반발기형화단측 Graf Ⅱa 형관관절이상병례유경고적관관절발육불량발생솔。결론Graf Ⅱa 형관관절이상병례중，18．6％적병례유관관절발육불량적가능，림상수밀절수방관찰，우기시유반발기형화단측발병적병례，단여림상은닉성관관절발육불량적관계유대진일보연구。
Objetive To determine the relationship between Graf Type IIa and DDH by retrospectively evaluating the outcome of the hip joint development,risk factors,associated anomalies and hip stability of Graf IIa hips.Methods A total of 5816 infants were examined by standardized ultrasonography method of Graf to screen hip abnormalities from January 2012 to June 2013.The incidence rate of Graf IIa hips and the rate of deterioration was calculated,and we assessed their relationship between DDH and the risk factors,associated anomalies,hip stability,affected sides and gender of hip abnormalities.Results A total of 172 hips were di-agnosed with Type IIa,and were found in 112 infants (6.4%).Twenty-four hips in 19 infants (18.6%) showed deterioration by ultrasound examination after an average of 10-week follow-up.Among these cases,18 hips in 14 infants were diagnosed with Graf Type IIb;3 hips in 2 infants with Graf Type IIc;2 hips in 2 infants with Graf Type D and 1 hip in 1 infant with Graf Type III.And there was likelihood that the infants associated with other anomalies and infants with only one side affected would have higher rate of deterioration. Conclu-sions Our study showed that 18.6% of infants diagnosed with Graf Type IIa had a risk of DDH,who needed close follow-ups,especially in those associated with other anomalies and those with only one side affected.Fur-ther study for the connection of Graf Type IIa hips with clinically occult dysplasia of the hip is still needed.