Transgluteal Ultrasonography in Spica Cast in the Post-reduction Assessment of Hip Developmental Dysplasia

作者全名："Xiao, Huan; Tang, Yi; Su, Yuxi"

作者地址："[Xiao, Huan; Tang, Yi] Chongqing Med Univ, Childrens Hosp, Dept Ultrasound, Chongqing, Peoples R China; [Su, Yuxi] Chongqing Med Univ, Childrens Hosp, Dept Orthoped, Chongqing, Peoples R China; [Xiao, Huan; Tang, Yi; Su, Yuxi] Key Lab Pediat, Chongqing, Peoples R China; [Xiao, Huan; Tang, Yi; Su, Yuxi] Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China; [Xiao, Huan; Tang, Yi; Su, Yuxi] Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China; [Xiao, Huan; Tang, Yi] China Int Sci & Technol Cooperat Base Child Dev &, Chongqing, Peoples R China; [Xiao, Huan; Su, Yuxi] Chongqing Med Univ, Jiangxi Hosp, Affiliated Childrens Hosp, Nanchang, Peoples R China; [Su, Yuxi] Chongqing Med Univ, Childrens Hosp, Chongqing 200014, Peoples R China"

通信作者："Su, YX (通讯作者)，Chongqing Med Univ, Childrens Hosp, Chongqing 200014, Peoples R China."

来源：ULTRASOUND IN MEDICINE AND BIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001141050300001

JCR分区：Q2

影响因子：2.4

年份：2024

卷号：50

期号：2

开始页：237

结束页：242

文献类型：Article; Early Access

关键词：Transgluteal; Ultrasound; Developmental dysplasia of the hip; Plaster fixation

摘要："Objective: Concentric circle reduction is one of the outcomes after reduction of developmental dysplasia of the hip (DDH). Radiography and magnetic resonance imaging (MRI) are used to confirm the reduction results. In this study, we evaluated the reduction results of the coronal section of the hip using transgluteal ultrasonography. Methods: We enrolled 46 children admitted to our hospital for closed or open reduction plaster fixation of DDH between January 2021 and December 2022. Thirty-eight patients had unilateral DDH, and eight patients had bilateral DDH. Transgluteal ultrasonography, radiography and MRI were done on the patients during the 7 d after reduction, and the results were interpreted by different radiologists. The covering of the femoral head and the dis-tance between the medial margin of the femoral head and the acetabulum (HSD) were measured after calculating the maximum coronal surface of the iliac bone. MRI is regarded as the gold standard for determining hip reduc-tion or dislocation. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of ultrasound and radiography were determined and compared. Results: The sensitivity, specificity, PPV and NPV of transgluteal ultrasonography were 100% (confidence interval [CI]: 69.2%-100%), 97.7% (CI: 88%-99.9%), 90.9% (CI: 59%-98.6%) and 100%, respectively, higher than those of radiography, which were 50% (CI: 18.7%-81.3%), 86.4% (CI: 72.6%-94.8%), 45.5% (CI: 24%-68.7%) and 88.4% (CI: 80.2%-93.5%), respectively. Ultrasonography had a higher sensitivity (100% vs. 50%, p < 0.01) and positive predictive rate (90.9% vs. 45.5%, p < 0.01) than radiography. Ultrasonography revealed that a distance between the head and socket (HSD) >8 mm indicated a strong suspicion for a poor reduction.Conclusion: Transgluteal coronal ultrasound scan with semiquantitative assessment of acetabular femoral head coverage and measurement of HSD can effectively monitor the reduction relationship between the two in children after DDH reduction."

基金机构：Chongqing Health and Family Planning Commission; Science and Technology Commission [2023MSXM026]; National Clinical Research Center for Child Health and Disorders [NCRCCHD-2022-GP-10]

基金资助正文："This study was funded by the Chongqing Health and Family Planning Commission with the Science and Technology Commission (2023MSXM026) , and National Clinical Research Center for Child Health and Disorders (NCRCCHD-2022-GP-10) ."