摘要
目的探讨Crowe I、Ⅱ型发育性髋关节发育不良(DDH)患者股骨近端畸形的特点和发病率。方法收集2012年6月至2014年4月77例(130髋)因确诊DDH于上海交通大学医学院附属新华医院骨科住院患者影像资料(双侧53例,单侧24例,男性23例,女性54例,年龄15~46岁)为DDH组,以同时期在该院进行体检或因其他疾病就诊的患者52例(56髋)作为对照组(男性13例,女性39例,年龄16~69岁)。应用Mimics软件对CT原始数据进行三维重建,在位置摆放统一的3D模型上进行髋关节解剖形态学参数测量。测量参数包括:股骨颈直径、股骨颈干角、股骨颈前倾角、α角、头颈偏心距。两组之间平均股骨颈长度差异采用t检验。两组之间髋内翻/髋外翻比例差异采用x^2检验,两组之间α角大于对照组平均值的阳性检出率和股骨头颈偏心距小于对照组平均值的阳性检出率差异采用x^2检验。结果对照组的平均股骨颈长度大于DDH患者组(t=5.05,P<0.01);平均股骨颈干角小于DDH患者组,但两者之间没有统计学差异(t=2.41,P>0.01)。DDH患者组平均股骨颈前倾角大于文献报道的正常值;58%的DDH患者至少有一处头颈偏心距小于对照组平均值,大于对照组的14%(x^2=25.84,P<0.01);至少有一处α角大于对照组平均值的有61%,远大于对照组的16%(P<0.01)。结论 DDH患者的股骨头颈偏距减小,α角增大,前倾角增大,行髋臼周围截骨术时应充分考虑股骨侧畸形对术后关节活动度和稳定性的影响。
Objective To investigate the incidence and characteristics of proximal femoral abnormalities in development dysplasia of the hip （DDH） （ Crowe I , II ）. Methods Imaging data of 77 cases （130 hips, June 2012 to April 2014） diagnosed as DDH in Xinhua Hospital, Affiliated to Shanghai Jiao Tong University were collected （bilateral 53 cases, unilateral 24 cases, 23 males and 54 females, aged 15 -46 years）. Another 52 patients （56 hips） were selected as the control group （13 males and 39 females, aged 16 -69 years ） , who were treated as physical examination or other diseases in the same hospital. The CT original data were reconstructed by Mimics software, and the anatomical morphological parameters of the hips were measured on 3D models. Measurement parameters included： femoral neck length （FNL）, femoral neck shaft angle （FNSA） , femoral neck antcversion angle （FNA）, alpha angle （α angle）, femoral head neck offset （HNO）. The mean FNL of the DDH group and of the control group were compared using the t test. The ratios of coxa varus / coxa valga of the two groups were compared by chi-square test. The positive ratios of the two groups which indicated α angle was greater than the mean value of the control group were compared by chi-square test. The positive ratios of the two groups which indicated HNO was smaller than the mean value of the control group were compared by chi-square test. Results The mean FNL in the control group was greater than that in the DDH group （ t = 5.05, P 〈 0. 01 ）. The average FNSA was smaller than that in the DDH group, but there was no significant difference between the two groups （ t = 2.41, P 〉 0. 01 ）. The average FNA of DDH patients was greater than that reported in the literature. Fifty eight percent of DDH patients had at least one head neck offset smaller than that of the control group （ 14% ） （χ^2= 25.84, P 〈 0. 01 ） . Sixty percent of DDH patients had at least one α angle greater than that of the control group （
作者
彭建平
王旭义
朱俊峰
沈超
崔一民
陈晓东
Peng Jianping Wang Xuyi Zhu Junfeng Shen Chao Cui Yimin Chen Xiaodong(Department of Orthopedic, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China)
出处
《中华关节外科杂志（电子版）》
CAS
2017年第3期10-15,共6页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
髋脱位
先天
股骨
畸形
Hip dislocation
Congenital
Femur
Abnormalities
