著者

原 幸比古

出版者

The Kitakanto Medical Society

雑誌

北関東医学 (ISSN:00231908)

巻号頁・発行日

vol.13, no.3, pp.143-168, 1963 (Released:2009-10-15)

参考文献数

48

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On the early diagnosis of congenital dislocation of the hip joint a number of ways have been studied and tried clinically or roentgenologically but none of them are satisfactory and so it is the most important problem to us today to establish the complete way of the diagnosis of it.By means of arthrography of the hip joints I examined 238 infants in the earlier half of suckling age who were diagnosed as suspicious condition or congenital dislocation of the hip joints by clinical pictures and roetgenographs. Those arthrograms were classified into seven types and compared with the clinical signs, namely the position of a limb and abduction test, and lateral displacement of femoral upper end and acetabular angle in roentgenograph, and as the result such conclusions were gained as follows.1) The adductioncontracture of the dislocated limb was odserved both at the flexion and the extension position of the limb and tended to be prominent in the case of great dislocation. Increase of the outward rotation of the dislocated limb in extension was seen mainly in some cases of great dislocation, while decrease of it was seen in many cases.2) In many cases of slight dislocation, the restriction of abduction was relatively small and showed the tendency to increase as the degree of dislocation became great. The click of the dislocated limb at the abduction test was able to be fell only in the case of great dislocation, and in the serious cases half or more than half of them could feel it.3) Iino's indcx showing the degree of lateral displacement of femoral upper end was inclined to increase as the degree of dislocation became great. The index of all the cases of great dislocation was over normal limit, but the index of a normal hip joint and that of a slight dislocated one of ten showed the same value and it was difficult to distinguish them.4) In the classification of the ilium morphologically by the ratio of height and width such results were gained as follows. In the case of wide ilium the normal acetabular angle showed a small value, so that in the case of great dislocation it was relatively small. In the case of narrow ilium the normal range of acetabular angle increased and so the acetabular angle of dislocation also tended to increase. It is the most important thing to consider the form of ilium in the measurement of the acetabular angle in the diagnosis of congenital dislocation of the hip joint.