신생아 고관절의 선별적 검사 및 선별적 초음파 검사

초록

PURPOSE The purpose of this paper was to evaluate the results and usefulness of neonatal hip screening using selective sonography prospectively. MATERIALS AND METHODS 3,954 neonates were clinically examined and hip sonographic examination, using Modified Graf method, was performed selectively in all neonates who had the sign of DDH or some of 'high risk' characteristics. RESULTS Sonographic examination was performed in 387 neonates (9.8%) . Nine neonates (0.23%) with positive Ortolani test, 14 (0.35%) with subluxatable or lax joints, 110 (2.78%) among 363 neonates (9.1%) with some of 'high risk' characteristics had follow-up sonographic examination because one or both hips didn't belong to type Ia of Graf classification. Graf type, angle a, angle b and head coverage percentage of hips, which had follow-up sonographic examination, were not significantly different enough to be used as a parameter to classify the degree of stability of hip by clinical examination. Additional dynamic sonography were helpful. Treatment were applied in 16 babies (0.4%) including 8 among 9 of positive Ortolani test, 3 among 14 of subluxatable hips and 5 among 110 with sonographically immature or dysplastic hips. CONCLUSION We detected DDH in neonatal periods by hip screening, and selective sonography was helpful in detecting sonographically unstable hips or dysplastic hips which were clinically stable.

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