CAJ | 학술논문

目的探讨髋关节造影、动态影像监测先天性髋关节脱位闭合复位前后的影像变化及其临床意义,并提出复位成功的指征.方法对23例34髋先天性髋关节脱位患儿进行髋关节造影,同时进行手法复位,对比研究复位前后影像变化并记录安全区限.结果 34髋中除4髋复位失败外,其余均一次复位成功.复位前23髋显示盂唇内翻,髋臼内"叉状"影像16髋,其中充盈缺损为圆韧带.23髋有"葫芦"状关节囊.中心复位后,盂唇内翻消失,并有"攻瑰刺"征出现.复位失败的4髋中有明显的囊颈狭窄,无一例股骨头坏死发生.结论髋关节造影、动态影像监测闭合复位先天性髋关节脱位能动态地确定复位的安全区限、髋关节是否中心复位及复位失败的内在障碍.髋关节中心复位的影像指征为股骨头顶点对向髋臼"Y"字软骨中心,"玫瑰刺"征出现,盂唇无内翻,髋关节内侧间隙变小,申通氏线连续.
목적 탐토관관절조영、동태영상감측선천성관관절탈위폐합복위전후적영상변화급기림상의의,병제출복위성공적지정.방법 대23례34관선천성관관절탈위환인진행관관절조영,동시진행수법복위,대비연구복위전후영상변화병기록안전구한.결과 34관중제4관복위실패외,기여균일차복위성공.복위전23관현시우진내번,관구내"차상"영상16관,기중충영결손위원인대.23관유"호호"상관절낭.중심복위후,우진내번소실,병유"공괴자"정출현.복위실패적4관중유명현적낭경협착,무일례고골두배사발생.결론 관관절조영、동태영상감측폐합복위선천성관관절탈위능동태지학정복위적안전구한、관관절시부중심복위급복위실패적내재장애.관관절중심복위적영상지정위고골두정점대향관구"Y"자연골중심,"매괴자"정출현,우진무내번,관관절내측간극변소,신통씨선련속.
Objective To assess the arthrographic changes under the image intensifier control and correlate them clinically.Methods Arthrographies were performed on 23 patients(34 hips)before and after closed reduction under image intensifier.The zones of safety were recorded.Results With the exception of 4 hips,all reductions were successful.Inverted limbuses were present in 23 hips.The redundant and hypertrophied ligamentum teres were shown as fork-shaped filling defect.Twenty-three hips had hour-glass appearance.After reduction,the inverted limbuses disappeared."Rose-thorn" feature appeared.Arthrography of the 4 failed reductions demonstrated hour-glass constriction of capsule.Conclusions Arthrography with image intensifier provides visualisation of safety zone and anatomical abnormalities during reduction of congenital dislocation of hip.