Acta Chir Orthop Traumatol Cech. 2000; 67(4):269-274
[Contemporary possibilities of the ultrasound diagnosis of developmental hip dislocation.].
- Klinika detské ortopedie FN. Brno.
The report is focussed on the last report of Graf et al., which was published in Stolzalpe as a manual for hip sonography in relation to the other contemporary publications from all the world, dealing with the same problem. It seems, that the assessment of hip joint abnormalities in Graf's classification is basically valid, not however the mode of the estimation of dynamic hip sonography. Not only due to the technically improper testing of the hip stability in extension of hip and knee, but as well as for the over-estimation of the displacement of the femoral head, which can produce false-positive findings. Graf's categorisation is still characterised by the over-categorisation of all abnormalities to many subgroups, which do not show always significant differences among themselves. The attitude to the treatment involving POP cast from D group including also newborns differs from all the experience summarised before in the world literature concerning the neonatal age, being limited usually on soft bandages and functional treatment. The recommendation to use overhead traction for subluxating newborn's hip (Graf's group III) does not correspond with the experience and results of many studies, which were performed yet before the era of ultrasound screening. Several reports of the other Czech authors were mentioned, which comply with the Graf's attitude and are even more aggressive in treatment program, starting the over-head traction from Graf's D group. Review of English, French and American literature is here counterweighted to the clinically improper appplica-tion of Graf's diagnostic scheme which however from the point of imaging is basically a good system.
Published: January 1, 2000 Show citation