《小儿外科学》课程教学课件（PPT讲稿）发育性髋关节发育不良 Developmental Dysplasia of the Hip（DDH）

Developmental Dysplasia ofthe Hip (发育性髋关节发育不良，DDH)》 2020.4

2020.4 Developmental Dysplasia of the Hip （ DDH）

Purposes to understand the cause,master pathology,clinical manifestations,x-ray features, differential diagnosis and treatment principles. 解病因，掌握病理、临床表现、X线特征、鉴别诊断、治疗原则) Main Difficulties Key Points:pathological changes,clinical manifestations and examinations,x-ray features,treatment principles.（病理改变、临床表现 及检查、治疗原则) Difficulties:physical examination,x-ray features,differential diagnosis 特征，鉴别诊断)

Purposes : to understand the cause, master pathology, clinical manifestations, x-ray features, differential diagnosis and treatment principles. Ⅰ Key Points : pathological changes, clinical manifestations and examinations, x-ray features, treatment principles.（ ） Ⅱ Difficulties : physical examination, x-ray features, differential diagnosis（ ）. Ⅲ Main Difficulties

I.Overview (I)Definition:DDH means taking a series of hip joint disorders in which the femoral head and abnormal in development or anatomy. 是在出生前或出生后股骨头和髋白在发育和/或解剖关系发生异常的一系列髋 关节病症

Ⅰ. Overview (Ⅰ) Definition: DDH means taking a series of hip joint disorders in which the femoral head and abnormal in development or anatomy

Congenital Dislocation of the Hip,CDH Developmental Dysplasia of the Hip DDH

Congenital Dislocation of the Hip, CDH Developmental Dysplasia of the Hip ，DDH

(Ⅱ)Epidemiology(流行病学) incidence rate 1 %0~1.5 %o 发病率：0.1-1.5% 1.White>Yellow>Black 1)白人>黄种人>黑人 2.north>south (China) 2)北方>南方（我国） 3.female>male (girls account for 80-90%) 3)男女之比1：5.36 4.left lateral bilateral right lateral 4)左侧>双侧>右侧

（ Ⅱ ）Epidemiology（流行病学） incidence rate 1 ‰ ~ 1.5 ‰ 1. White>Yellow>Black 2. north>south（China） 3. female>male（girls account for 80-90%) 4. left lateral > bilateral > right lateral

IⅡ.Pathogenesis(病因) multiple factors,regulated by hormones and genes I Anatomical Defects prepared for delivery from the 16th week of pregnancy-hip instability II Mechanical Factors Theory 1.Prenatal:Most often,the left hip is stressed,the left side is good. 2.In Production:Breech production,the incidence rate is 5 times higher. 3.Postpartum:Swaddling clothes,North>South

Ⅱ. Pathogenesis（病因） multiple factors, regulated by hormones and genes （ Ⅰ ）Anatomical Defects prepared for delivery from the 16th week of pregnancy→hip instability （ Ⅱ ）Mechanical Factors Theory 1.Prenatal: Most often, the left hip is stressed, the left side is good. 2.In Production: Breech production, the incidence rate is 5 times higher. 3.Postpartum: Swaddling clothes, North>South

(III)The Theory of Hormone-Induced Joint Relaxation Relaxin.Girls are susceptible. female male (IV)Genetic Theory: 1.family history 2.racial differences:White>Black 3.often accompanied by other malformations

(Ⅲ) The Theory of Hormone-Induced Joint Relaxation Relaxin. Girls are susceptible. female > male (Ⅳ) Genetic Theory： 1. family history 2. racial differences: White>Black 3. often accompanied by other malformations

Ⅲ.Pathology (病理) (I)Changes in the Skeleton 1.Femoral Head:small,irregular 2.Acetabulum:shallow and oblique,thick inner wall,forward leaning1,false acetabulum. 3.Femoral Neck:short and thick,the angle of forward leaning1 Normal DDH

Ⅲ . Pathology（病理） (Ⅰ) Changes in the Skeleton 1.Femoral Head: small, irregular 2.Acetabulum: shallow and oblique, thick inner wall, forward leaning↑, false acetabulum. 3.Femoral Neck: short and thick, the angle of forward leaning↑. Normal DDH

Pelvis and Spine Unilateral:pelvic tilt,compensatory scoliosis of the spine Bilateral:The lumbar lordosis is intensified,and the hips are protruding

Pelvis and Spine Unilateral: pelvic tilt, compensatory scoliosis of the spine Bilateral: The lumbar lordosis is intensified，and the hips are protruding

(II)Soft Tissue Changes 1.Glenoid Labrum（鱼唇)-thickening,valgus,involution 2.Joint Capsule(关节囊)-pulling,deforming 3.Round Ligament(圆韧带)-pulling 4.Muscle Fascia（筋膜)-spasming and shrinking 5.Ligamentum Transversum Acetabul(横韧带)i-thickening,introrsus Normal DDH

(Ⅱ) Soft Tissue Changes 1.Glenoid Labrum（鱼唇） - thickening, valgus, involution 2.Joint Capsule （关节囊）- pulling, deforming 3.Round Ligament（圆韧带） - pulling 4.Muscle Fascia （筋膜）- spasming and shrinking 5.Ligamentum Transversum Acetabul（横韧带）i - thickening, introrsus Normal DDH