摘要
目的探讨成人单侧髋关节发育不良 （developmental dysplasia of the hip, DDH）Crowe分型与骨盆不对称的相关性。方法2012年1月至2014年2月收治住院的明确诊断为单侧DDH、年龄〉18岁且有标准骨盆正位x线片的患者100例，男22例，女78例；年龄21~79岁，平均为56．3岁。Crowe分型I型30例、Ⅱ型24例、Ⅲ型23例、Ⅳ型23例。测量骨盆正位x线片上健侧及患侧骨盆垂直高度（从坐骨结节到同侧髂嵴最高点的垂直距离），比较健侧及患侧骨盆垂直高度的差异，并分析这种差异与Crowe分型的相关性。结果100例成人单侧DDH患者健侧骨盆垂直高度平均为（23．38±1．46）cm，患侧骨盆垂直高度平均为（22．41±1．38）cm，骨盆垂直高度差平均为（0．98±0．76）cm。CroweI型至CroweⅣ型，健侧骨盆垂直高度分别为（22．88±1．09）cm、（23．23±2．07）cm、（23．75±1．16）cm、（23．79±1．22）cm，患侧骨盆垂直高度分别为（22．70±0．98）cm、（22．41±1．98）om、（22．47±1．12）om、（21．92±1．32）cm，骨盆垂直高度差分别为（0．19±0．37）cm、（0．82±0．43）cm、（1．28±0．32）cm、（1．87±0．59）on，不同分型组患者骨盆垂直高度差的差异有统计学意义。从CroweⅠ型至CroweⅣ型骨盆垂直高度差逐渐增大，骨盆垂直高度差与患侧髋关节脱位程度呈正相关（Y=7．61±0．124，r=0．819，P=O．000）。结论成人单侧DDH患者存在影像学上的骨盆不对称现象，两侧骨盆垂直高度差的大小与患侧髋关节脱位程度呈正相关。
Objective To investigate the relationship between pelvic asymmetry and Crowe classification of unilateral developmental dysplasia of the hip in adults. Methods According to the inclusion criteria, 100 cases of unilateral DDH in adults were collected, including 78 females and 22 males, with an average age of 56.3 years old （range, 21-79 years）. In terms of Crowe classification, there were 30 cases of Crowe type Ⅰ, 24 cases of Crowe type Ⅱ, 23 cases of Crowe type Ⅲ, and 23 cases of Crowe Ⅳ. The normal-side and affected-side pelvic vertical height （the distance from the highest point of the ischial tuberosity to the iliac crest peak） were measured via the radiogram of anteroposterior pelvis. Furthermore, we compared the affected-side pelvic vertical height with the normal-side and analyzed the relationship between Crowe classification and the difference in pelvic verti- cal height. Results The average pelvic vertical height was 23.38±1.46 cm in the normal-side and 22.41±1.38 cm in the affected- side. The average D-value of pelvic vertical height between two sides is 0.98±0.76 cm. From Crowe type I to IV, the average heights of the normal-side were 22.89±1.09 cm, 23.23±2.07 cm, 23.75±1.16 era, 23.79±1.22 cm, while those of the affected-side were 22.70＋0.98 cm, 22.41±1.98 cm, 22.47±1.12 cm and 21.92±1.32 cm. The average D-values in each group were 0.19±0.37 cm, 0.82±0.43 cm, 1.28±0.32 cm, 1.87±0.59 em. The differences between the normal-side and the affected-side in each type were statistically significant. The average D-value increased significantly with Crowe type increased, and there was a positive correla- tion between the D-value of bilateral pelvic vertical height and the degree of hip dislocation. Conclusion The pelvic asymmetry does exist in adult patients with unilateral developmental dysplasia of the hip. Moreover, the asymmetry has positive correlation with the degree of hip dislocation.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2014年第12期1231-1235,共5页
Chinese Journal of Orthopaedics
关键词
髋脱位
先天性
骨盆
成年人
Hip dislocation, congenital
Pelvis
Adult
