腦性麻痺導致髖關節脫臼之臨床探討

Acquired Hip Subluxation and Dislocation in Cerebral Palsy

董莉貞(Li-Chen Tung) ； 王淳厚(Chun-Hou Wang) ； 黃玉慧(Yu-Hui Huang) ； 畢柳鶯(Liu-Ing Bih)

《中華民國復健醫學會雜誌》 26卷4期 (1998/12) Pp. 189-195

摘要

本研究收集85年9月至86年3月間於本院門診追蹤之腦性麻痺病人共89位，其中男性46位、女性43位，平均年齡6.0±3.4歲。共178個髖關節接受骨盆部位X光檢查，根據X光片影像測得脫臼比率(migration percentage)及髖臼指數(acetabular index)。髖關節脫臼的認定乃依據Reimers的定義：脫臼比率達33%以上者稱為髖關節半脫臼(hip subluxation)，脫臼比率大於100%則稱為髖關節完全脫臼(hip dislocation)。研究結果顯示髖關節半脫臼39例（佔43.8%），完全脫臼4例（佔4.5%）。根據皮爾森相關檢定(Pearson correlation coefficients)顯示脫臼比率與髖臼指數及髖臼指數與髖關節脫臼互有相關性。發生髖關節脫臼的43位病患中38位僅接受保守治療，五位接受手術治療的脫臼病人中有四位術後除了脫臼比率有改善外身體功能也有進步。本研究目的希望藉由測量脫臼比率及髖臼指數作為初步篩檢方法，以早期發現髖關節脫臼並且給予適當處理。

關鍵字

腦性麻痺 ； 髖關節半脫臼 ； 髖關節完全脫臼 ； 脫臼比率 ； 髖臼指數

並列摘要

The study group comprised eighty-nine cerebral palsy patients, 46 males and 43 females. The average age was 6.0±3.4 years old. Pelvic frontal view radiographs were made in a total of 178 hips. The migration percentage and acetabular index were measured by pelvic X-ray in all patients. Either hip subluxation or dislocation was diagnosed according to the criteria of Reimers, who considered a migration percentage greater than 33% to denote subluxation and a percentage greater than 100% to be denoted as dislocation. An overall incidence of hip subluxation and dislocation of 48.3% was found. According to the Pearson correlation coefficients data, migration percentage, acetabular index and hip dislocation were correlated. A total of forty-three patients (48.3%) had hip subluxation or dislocation. Thirty-eight of these 43 patients received conservative treatment. The postoperative migration percentages and physical function improved in four out of five patients. We utilized the measurement of migration percentage and acetabular index for hip dislocation screening. Early diagnosis and early treatment appeared to be able to improve patients' function and life quality.

並列關鍵字

cerebral palsy ； hip subluxation ； hip dislocation ； migration percentage ； acetabular index