背景:因骨盆解剖结构较为复杂,与多个重要脏器、血管、神经毗邻,通过传统方法治疗复杂髋关节疾病的操作难度较大。利用3D打印技术显著提升了此类疾病的手术成功率及患者满意度。目的:归纳3D打印技术在髋关节疾病治疗中的应用效果。方法...背景:因骨盆解剖结构较为复杂,与多个重要脏器、血管、神经毗邻,通过传统方法治疗复杂髋关节疾病的操作难度较大。利用3D打印技术显著提升了此类疾病的手术成功率及患者满意度。目的:归纳3D打印技术在髋关节疾病治疗中的应用效果。方法:利用计算机检索CNKI、PubMed数据库2000年1月至2019年3月发表的相关文献,中文检索词为“3D打印技术,发育性髋关节发育不良,骨盆骨折,髋臼骨折,骨盆肿瘤,髋臼肿瘤、髋关节置换”,英文检索词为“3D printing,developmental dysplasia of the hip,DDH,pelvic fracture,acetabular fracture,pelvic tumor,acetabular tumor,replacement or the hip joint”。共检索到103篇文章,根据纳入与排除标准最终纳入41篇文献进行综述。结果与结论:3D打印的优势在于不需要模具,直接通过数字化技术制造复杂的几何模具或模型。将3D打印技术应用在发育性髋关节发育不良、复杂的骨盆及髋臼骨折与髋关节肿瘤的临床治疗中,显著提高了患者满意度,减少了并发症的发生。因此,将3D打印技术用于髋关节疾病的诊治对髋关节疾病的术前指导、术中操作以及术后康复都具有重要临床意义与广阔的应用前景。展开更多
Background Treating developmental dysplasia of the hip is often challenging. The difficulties include not only the hip surgery itself but also the treatment of the associated lower-limb valgus deformity. However, ther...Background Treating developmental dysplasia of the hip is often challenging. The difficulties include not only the hip surgery itself but also the treatment of the associated lower-limb valgus deformity. However, there have been very few studies on such deformity in patients with developmental hip dysplasia. In this study, we investigated the prevalence and severity of lower-limb valgus deformity, along with the relationship between the severity of valgus deformity and mechanical alterations of the hip or the ipsilateral knee. Methods Two hundred and six affected lower limbs of 116 adult patients with untreated developmental dysplasia of the hip were included in the study, grouped according to the severity of hip dysplasia. Each study participant＇s radiographs were measured to quantitatively evaluate the mechanical axis deviation of the lower limb, and further to evaluate the prevalence and severity of the lower-limb valgus deformity. Some mechanical alterations of the hip and the ipsilateral knee were also measured on the radiographs. Results Of the affected lower limbs, 14.1% had valgus deformities. Study participants with Crowe type III hip dysplasia had the most severe deformity and the highest prevalence of deformity. Severity of valgus deformity had a strong positive correlation with the lateral migration of the femoral head but not with the superior migration. A decreased lateral distal femoral angle contributed to the lower-limb valgus deformity, and the lateral distal femoral angle had a strong negative correlation with the severity of valgus deformity. Conclusions Hip dysplasia is commonly associated with lower-limb valgus deformity, and the severity of the lower-limb valgus deformity is mostly affected by lateral migration but not superior migration of the femoral head. The valgus deformity may originate mainly in the distal femur, in addition to the hip joint itself. These findings can be taken into account when planning to treat the patients with hip dysplasia.展开更多
目的探究分析婴幼儿发育性髋关节发育不良(DDH)的危险因素。方法回顾性分析本院在2022年1月至2024年3月收治的166例可疑DDH婴幼儿的病历资料,按不同月龄选择不同的影像学检查:即0~6月婴幼儿采取Graf法超声检查;≥7月婴幼儿采用X线检查...目的探究分析婴幼儿发育性髋关节发育不良(DDH)的危险因素。方法回顾性分析本院在2022年1月至2024年3月收治的166例可疑DDH婴幼儿的病历资料,按不同月龄选择不同的影像学检查:即0~6月婴幼儿采取Graf法超声检查;≥7月婴幼儿采用X线检查。根据影像学诊断结果,将研究对象分为髋关节发育不良阳性组与阴性组,其中阳性组73例,阴性组93例,收集2组资料,并采用多因素广义线性回归分析法(Logistic)分析婴幼儿DDH的危险因素。结果阳性组患儿的性别、家族遗传史、臀位、羊水量<300 mL、头胎、多胎、传统襁褓、首检月龄、髋关节弹响、肌性斜颈例数均多于阴性组,差异有统计学意义(P<0.05);多因素Logistic分析,女性、有家族遗传史、臀位、羊水量<300 m L、头胎、多胎、有传统襁褓史、首检月龄≥3个月、有髋关节弹响、有肌性斜颈情况是婴幼儿DDH的危险因素(P<0.05)。结论婴幼儿是女性、有家族遗传史、臀位、羊水量<300 mL、头胎、多胎、有传统襁褓史、首检月龄≥3个月以及检查合并有髋关节弹响、肌性斜颈情况可能会出现DDH,针对各影响因素为降低婴幼儿DDH发生提供参考。展开更多
目的探究0~6个月婴幼儿发育性髋关节发育不良(developmental dysplasia of the hip,DDH)行Graf法超声诊断的临床意义。方法将2015年5月—2022年2月在郑州大学附属儿童医院诊治的12708例疑似DDH婴幼儿(0~6个月)作为研究对象,所有患儿均行...目的探究0~6个月婴幼儿发育性髋关节发育不良(developmental dysplasia of the hip,DDH)行Graf法超声诊断的临床意义。方法将2015年5月—2022年2月在郑州大学附属儿童医院诊治的12708例疑似DDH婴幼儿(0~6个月)作为研究对象,所有患儿均行Graf法超声诊断,分析Graf法超声诊断结果、Graf分型情况,对比异常髋关节与正常髋关节的α与β角、超声声像图特征,对异常髋关节患儿进行临床干预与复查随访并分析结果。结果本研究共纳入研究对象12708例,其中男5210例、女7498例;共筛查25416髋,其中DDH(Graf IIa及以上)966髋、占总髋数的3.8%;DDH患儿总例数为438例,其中女性DDH患儿共300例,占68.49%,0~3月龄DDH患儿313例;与正常髋关节相比,DDH髋关节α角更小,β角更大(P<0.05)。结论0~6个月婴幼儿DDH行Graf法超声诊断具有便捷、可重复、无创等优点,同时对软组织与软骨具有较高分辨率,可有效显示出DDH情况。展开更多
[目的]分析本院发育性髋关节发育不良(developmental dysplasia of the hip, DDH)患儿延误确诊的影响因素,为DDH相关公共卫生政策的制定和推行提供科学依据。[方法] 2011年1月—2020年12月西京医院收治的7岁以下DDH患儿325例作为研究对...[目的]分析本院发育性髋关节发育不良(developmental dysplasia of the hip, DDH)患儿延误确诊的影响因素,为DDH相关公共卫生政策的制定和推行提供科学依据。[方法] 2011年1月—2020年12月西京医院收治的7岁以下DDH患儿325例作为研究对象,根据确诊时患儿年龄分为非延误组(确诊年龄0~6个月)和延误组(确诊年龄7~84个月)。调查患儿的基本信息、家庭信息和诊疗信息。对不同确诊月龄与超声Graf分型和影像Crowe分型的关系进行Spearman相关性分析,而后根据分组进行单因素分析及多因素logistic回归分析。[结果] 325例患儿(432髋)中,非延误组72例,占22.15%;延误组253例,占77.85%。非延误组患儿确诊月龄与超声Graf分型呈负相关性(R=-0.284,P=0.016)。延误组患儿确诊月龄与影像Crowe分型呈正相关性(R=0.144,P=0.023)。多因素逻辑回归表明,家庭经济条件差(OR=1.722,P=0.001)、母亲受教育程度低(OR=1.429,P=0.047)、未进行早期髋筛查(OR=7.215,P<0.001)是DDH患儿延误确诊的独立危险因素。[结论] 6个月以下确诊患儿确诊月龄与超声Graf分型呈弱负相关,7个月以上确诊患儿确诊月龄与影像Crowe分型呈弱正相关。家庭经济条件差、母亲受教育程度低、未进行早期髋关节筛查是DDH患儿延误确诊危险因素。展开更多
AIM To determine if there was a seasonal variation in adults undergoing total hip arthroplasty for end stage hip disease due to osteoarthritis(OA) or sequelae of developmental dysplasia of the hip(DDH).METHODS The tot...AIM To determine if there was a seasonal variation in adults undergoing total hip arthroplasty for end stage hip disease due to osteoarthritis(OA) or sequelae of developmental dysplasia of the hip(DDH).METHODS The total hip registry from the author's institution for the years 1969 to 2013 was reviewed. The month of birth,age,gender,and ethnicity was recorded. Differences between number of births observed and expected in the winter months(October through February) and non-winter mo(March through September) were analyzed with the χ2 test. Detailed temporal variation was mathematically assessed using cosinor analysis.RESULTS There were 7792 OA patients and 60 DDH patients who underwent total hip arthroplasty. There were more births than expected in the winter months for both the DDH(P < 0.0001) and OA(P = 0.0052) groups. Cosinor analyses demonstrated a peak date of birth on 1st October. CONCLUSION These data demonstrate an increased prevalence of DDH and OA in those patients born in winter.展开更多
文摘背景:因骨盆解剖结构较为复杂,与多个重要脏器、血管、神经毗邻,通过传统方法治疗复杂髋关节疾病的操作难度较大。利用3D打印技术显著提升了此类疾病的手术成功率及患者满意度。目的:归纳3D打印技术在髋关节疾病治疗中的应用效果。方法:利用计算机检索CNKI、PubMed数据库2000年1月至2019年3月发表的相关文献,中文检索词为“3D打印技术,发育性髋关节发育不良,骨盆骨折,髋臼骨折,骨盆肿瘤,髋臼肿瘤、髋关节置换”,英文检索词为“3D printing,developmental dysplasia of the hip,DDH,pelvic fracture,acetabular fracture,pelvic tumor,acetabular tumor,replacement or the hip joint”。共检索到103篇文章,根据纳入与排除标准最终纳入41篇文献进行综述。结果与结论:3D打印的优势在于不需要模具,直接通过数字化技术制造复杂的几何模具或模型。将3D打印技术应用在发育性髋关节发育不良、复杂的骨盆及髋臼骨折与髋关节肿瘤的临床治疗中,显著提高了患者满意度,减少了并发症的发生。因此,将3D打印技术用于髋关节疾病的诊治对髋关节疾病的术前指导、术中操作以及术后康复都具有重要临床意义与广阔的应用前景。
文摘Background Treating developmental dysplasia of the hip is often challenging. The difficulties include not only the hip surgery itself but also the treatment of the associated lower-limb valgus deformity. However, there have been very few studies on such deformity in patients with developmental hip dysplasia. In this study, we investigated the prevalence and severity of lower-limb valgus deformity, along with the relationship between the severity of valgus deformity and mechanical alterations of the hip or the ipsilateral knee. Methods Two hundred and six affected lower limbs of 116 adult patients with untreated developmental dysplasia of the hip were included in the study, grouped according to the severity of hip dysplasia. Each study participant＇s radiographs were measured to quantitatively evaluate the mechanical axis deviation of the lower limb, and further to evaluate the prevalence and severity of the lower-limb valgus deformity. Some mechanical alterations of the hip and the ipsilateral knee were also measured on the radiographs. Results Of the affected lower limbs, 14.1% had valgus deformities. Study participants with Crowe type III hip dysplasia had the most severe deformity and the highest prevalence of deformity. Severity of valgus deformity had a strong positive correlation with the lateral migration of the femoral head but not with the superior migration. A decreased lateral distal femoral angle contributed to the lower-limb valgus deformity, and the lateral distal femoral angle had a strong negative correlation with the severity of valgus deformity. Conclusions Hip dysplasia is commonly associated with lower-limb valgus deformity, and the severity of the lower-limb valgus deformity is mostly affected by lateral migration but not superior migration of the femoral head. The valgus deformity may originate mainly in the distal femur, in addition to the hip joint itself. These findings can be taken into account when planning to treat the patients with hip dysplasia.
文摘目的探究分析婴幼儿发育性髋关节发育不良(DDH)的危险因素。方法回顾性分析本院在2022年1月至2024年3月收治的166例可疑DDH婴幼儿的病历资料,按不同月龄选择不同的影像学检查:即0~6月婴幼儿采取Graf法超声检查;≥7月婴幼儿采用X线检查。根据影像学诊断结果,将研究对象分为髋关节发育不良阳性组与阴性组,其中阳性组73例,阴性组93例,收集2组资料,并采用多因素广义线性回归分析法(Logistic)分析婴幼儿DDH的危险因素。结果阳性组患儿的性别、家族遗传史、臀位、羊水量<300 mL、头胎、多胎、传统襁褓、首检月龄、髋关节弹响、肌性斜颈例数均多于阴性组,差异有统计学意义(P<0.05);多因素Logistic分析,女性、有家族遗传史、臀位、羊水量<300 m L、头胎、多胎、有传统襁褓史、首检月龄≥3个月、有髋关节弹响、有肌性斜颈情况是婴幼儿DDH的危险因素(P<0.05)。结论婴幼儿是女性、有家族遗传史、臀位、羊水量<300 mL、头胎、多胎、有传统襁褓史、首检月龄≥3个月以及检查合并有髋关节弹响、肌性斜颈情况可能会出现DDH,针对各影响因素为降低婴幼儿DDH发生提供参考。
文摘目的探究0~6个月婴幼儿发育性髋关节发育不良(developmental dysplasia of the hip,DDH)行Graf法超声诊断的临床意义。方法将2015年5月—2022年2月在郑州大学附属儿童医院诊治的12708例疑似DDH婴幼儿(0~6个月)作为研究对象,所有患儿均行Graf法超声诊断,分析Graf法超声诊断结果、Graf分型情况,对比异常髋关节与正常髋关节的α与β角、超声声像图特征,对异常髋关节患儿进行临床干预与复查随访并分析结果。结果本研究共纳入研究对象12708例,其中男5210例、女7498例;共筛查25416髋,其中DDH(Graf IIa及以上)966髋、占总髋数的3.8%;DDH患儿总例数为438例,其中女性DDH患儿共300例,占68.49%,0~3月龄DDH患儿313例;与正常髋关节相比,DDH髋关节α角更小,β角更大(P<0.05)。结论0~6个月婴幼儿DDH行Graf法超声诊断具有便捷、可重复、无创等优点,同时对软组织与软骨具有较高分辨率,可有效显示出DDH情况。
文摘[目的]分析本院发育性髋关节发育不良(developmental dysplasia of the hip, DDH)患儿延误确诊的影响因素,为DDH相关公共卫生政策的制定和推行提供科学依据。[方法] 2011年1月—2020年12月西京医院收治的7岁以下DDH患儿325例作为研究对象,根据确诊时患儿年龄分为非延误组(确诊年龄0~6个月)和延误组(确诊年龄7~84个月)。调查患儿的基本信息、家庭信息和诊疗信息。对不同确诊月龄与超声Graf分型和影像Crowe分型的关系进行Spearman相关性分析,而后根据分组进行单因素分析及多因素logistic回归分析。[结果] 325例患儿(432髋)中,非延误组72例,占22.15%;延误组253例,占77.85%。非延误组患儿确诊月龄与超声Graf分型呈负相关性(R=-0.284,P=0.016)。延误组患儿确诊月龄与影像Crowe分型呈正相关性(R=0.144,P=0.023)。多因素逻辑回归表明,家庭经济条件差(OR=1.722,P=0.001)、母亲受教育程度低(OR=1.429,P=0.047)、未进行早期髋筛查(OR=7.215,P<0.001)是DDH患儿延误确诊的独立危险因素。[结论] 6个月以下确诊患儿确诊月龄与超声Graf分型呈弱负相关,7个月以上确诊患儿确诊月龄与影像Crowe分型呈弱正相关。家庭经济条件差、母亲受教育程度低、未进行早期髋关节筛查是DDH患儿延误确诊危险因素。
文摘AIM To determine if there was a seasonal variation in adults undergoing total hip arthroplasty for end stage hip disease due to osteoarthritis(OA) or sequelae of developmental dysplasia of the hip(DDH).METHODS The total hip registry from the author's institution for the years 1969 to 2013 was reviewed. The month of birth,age,gender,and ethnicity was recorded. Differences between number of births observed and expected in the winter months(October through February) and non-winter mo(March through September) were analyzed with the χ2 test. Detailed temporal variation was mathematically assessed using cosinor analysis.RESULTS There were 7792 OA patients and 60 DDH patients who underwent total hip arthroplasty. There were more births than expected in the winter months for both the DDH(P < 0.0001) and OA(P = 0.0052) groups. Cosinor analyses demonstrated a peak date of birth on 1st October. CONCLUSION These data demonstrate an increased prevalence of DDH and OA in those patients born in winter.
