Recent advances in ultrasound technology now permit direct access to foetal structures with visualisation of foetal hip development. Since early diagnosis and treatment of congenital hip dislocation significantly influence outcome of the disease, ultrasound screening of newborn infants proved to be the most effective method. In our study assessment of the foetal hip has been carried out to provide basic knowledge on foetal hip development from 14.-40. weeks of gestation. Technique of foetal hip ultrasound is presented. Diagnosis should include qualitative and quantitative descriptions of foetal hip structures. Alpha and Beta angles according to Graf's classification are frequently measurable from the 21st week of gestation, but tend to be more reliable towards the end of pregnancy.
Although etiology and pathogenesis of congenital dislocation of the hip (CDH) is of broad interest in orthopaedics, basic questions still remain obscure. Advances in high-resolution ultrasound technology now permit investigation of the fetal hip joint in vivo. Standard values of intrauterine hip development have been established by investigating 146 fetuses (141 pregnancies) in vivo by ultrasound. Standard values describe the development from 20th weeks of gestation until birth. Prenatal Alpha- values suggest influence of intrauterine posture and spatial fetal conditions on hip development. Alpha-angles of 59.7 (SD 8.9) are achieved at the end of pregnancy. These angles meet standards of Graf's calculations for the postnatal hip development. Standard values of intrauterine hip development are of basic interest for interpretation of hip joints in premature children.
Our results suggest that when utilising a histocytological method to determine metal sensitivity of a biomaterial on surrounding soft tissue, not only material directly adjacent to the implant but also at a distance of approximately 1 cm should be evaluated.
The basic arterial pattern of the hip joint is established at birth. Proximal end of the growing femur, acetabulum, os ilium and labrum acetabulare are clearly visible by ultrasound.
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