Výskyt prenatálních irreponibilních luxací kycelního kloubu u novorozenců.
Coleman differentiated in his recent classification hip dislocations to three groups: Usual (typical) dislocations, Prenatal hip dislocations (irreducible at birth) and Teratologic hip dislocations found together with arthrogryposis or neuromuscular diseases. Hip dislocations in cases of spina bifida are excluded as there is another mechanism of development. In the late-phase it is quite impossible to differentiate a developed typical hip dislocation from prenatal hip dislocation. Authors in this study analysed the all material of the long-lasting prospective epidemiologic study 1984-1995 involving clinical and ultrasonographical examination of 56.820 new-borns. Contrary to typical hip dislocation which is in the first few days reducible, prenatal dislocation is characterised by the high-riding great trochanters, limited abduction and a failed attempt of reduction. Ultrasound depicts high-riding dislocation with the femoral head lying laterally to the iliac wing, reduction test in the dynamic US scan is impossible. Six prenatal-irreducible hip dislocations were selected. These were submitted to further analysis concerning the sex, birth weight, surgical finding and early outcome of treatment. On the other side there were 810 early- and 52 lately-treated DDH cases, which in all but one did not need open reduction and were cured completely by conservative methods. One exemption was a case, at whom mother broke the therapy from the first week. Key words: prenatal hip dislocation, antenatal hip dislocation, teratological hip dislocation.
Poul M D Phd
J
J
Department of Pediatric Orthopaedic, Children's Hospital Masaryk University Brno.