[Determination of femoral head position with transinguinal ultrasound in DDH treatment].
OBJECTIVE
Determination of the femoral head position after closed or open reduction and application of a spica cast is possible by X-ray, MRI, CT or transinguinal ultrasound. In this study we compared the efficacy of transinguinal ultrasound and radiography. Further options with transinguinal ultrasound such as the determination of soft tissue and intraoperative possibilities are also described.


METHODS
In a first cohort of 25 patients with 33 affected hips ultrasound and radiography were compared. In a second cohort of 8 patients with 11 affected hips ultrasound and arthrography were compared.


RESULTS
32 radiographs proved to be not useful for the precise determination of the femoral head position. In all ultrasound images the criteria described by van Douveren et al. could be identified. All ultrasound images in the study were useful and gave reliable information with regard to the femoral head position.


CONCLUSIONS
Consequently, standard radiographic documentation is no longer used as a standard in our clinic. MRI and CT are reserved for special cases. We recommend transinguinal ultrasound as a standard diagnostic method for determination of the femoral head position in hip spica casts. With a portable ultasound system, determination of the hip position using transinguinal ultrasound is immediately possible in the operating theatre.
Eberhardt
O
O
Orthopädische Klinik, Olgahospital Stuttgart. o.eberhardt@klinikum-stuttgart.de
Zieger
M
M
Wirth
T
T
Fernandez
F F
FF
D001175:Arthrography; D002370:Casts, Surgical; D003661:Decision Support Techniques; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging*; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007264:Inguinal Canal / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D013165:Splints; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography