中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2013年
6期
513-517
,共5页
髋脱位,先天性%人体测量术%下肢%关节疾病
髖脫位,先天性%人體測量術%下肢%關節疾病
관탈위,선천성%인체측량술%하지%관절질병
Hip dislocation,congenital%Anthropometry%Lower extremity%Joint diseases
目的 观察骨骼发育成熟的单侧发育性髋关节完全脱位的患者脱位侧下肢长度的变化特点及伴随膝关节畸形的情况.方法 选择201 1年3月至2012年12月因单侧髋关节完全脱位接受治疗且符合纳入排除标准的28例患者作为观察对象,其中男性6例,女性22例；年龄13.4～66.2岁,平均29.8岁.脱位侧为中低位脱位(HartofilakidisⅡ型)17例(60.7％),高位脱位(HartofilakidisⅢ型)11例(39.3％).患者均行站立位双下肢全长正位X线检查,于X线片上进行双侧股骨及胫骨绝对长度、下肢相对长度的测量,并观察脱位侧与非脱位侧膝关节畸形情况.对股骨绝对长度、胫骨绝对长度、双下肢相对长度及双侧膝外翻角采用配对资料t检验进行统计学分析；对膝外翻分布规律及不同脱位程度下肢相对长度的分布规律采用x2或校正x2检验.结果 脱位侧股骨绝对长度较非脱位侧延长者17例(60.7％),最长延长32.7 mm,平均延长9.5 mm,差异无统计学意义(t=1.328,P=0.197).脱位侧胫骨绝对长度较非脱位侧延长者21例(75.0％),最长延长10.9 mm,平均延长4.5 mm,差异有统计学意义(t=3.039,P=0.006).脱位侧下肢相对长度较非脱位侧延长者20例(71.4％),最长延长25.0 mm,平均延长9.4 mm,差异有统计学意义(t=2.451,P=0.022).脱位侧膝外翻角为3.±4°,非脱位侧膝外翻角为-3°±4°,双侧对比差异有统计学意义(t=5.642,P=0.000)；其中脱位侧膝外翻畸形12例,膝内翻1例；而非脱位侧膝内翻畸形15例,膝外翻畸形1例,差异有统计学意义(x2=18.139,P=0.000).结论 大多数单侧髋关节完全脱位患者脱位侧患肢长度较非脱位侧延长,其中股骨和胫骨均有延长.脱位侧出现膝外翻畸形的发生率较高,而非脱位侧膝内翻的发生率高.
目的 觀察骨骼髮育成熟的單側髮育性髖關節完全脫位的患者脫位側下肢長度的變化特點及伴隨膝關節畸形的情況.方法 選擇201 1年3月至2012年12月因單側髖關節完全脫位接受治療且符閤納入排除標準的28例患者作為觀察對象,其中男性6例,女性22例；年齡13.4～66.2歲,平均29.8歲.脫位側為中低位脫位(HartofilakidisⅡ型)17例(60.7％),高位脫位(HartofilakidisⅢ型)11例(39.3％).患者均行站立位雙下肢全長正位X線檢查,于X線片上進行雙側股骨及脛骨絕對長度、下肢相對長度的測量,併觀察脫位側與非脫位側膝關節畸形情況.對股骨絕對長度、脛骨絕對長度、雙下肢相對長度及雙側膝外翻角採用配對資料t檢驗進行統計學分析；對膝外翻分佈規律及不同脫位程度下肢相對長度的分佈規律採用x2或校正x2檢驗.結果 脫位側股骨絕對長度較非脫位側延長者17例(60.7％),最長延長32.7 mm,平均延長9.5 mm,差異無統計學意義(t=1.328,P=0.197).脫位側脛骨絕對長度較非脫位側延長者21例(75.0％),最長延長10.9 mm,平均延長4.5 mm,差異有統計學意義(t=3.039,P=0.006).脫位側下肢相對長度較非脫位側延長者20例(71.4％),最長延長25.0 mm,平均延長9.4 mm,差異有統計學意義(t=2.451,P=0.022).脫位側膝外翻角為3.±4°,非脫位側膝外翻角為-3°±4°,雙側對比差異有統計學意義(t=5.642,P=0.000)；其中脫位側膝外翻畸形12例,膝內翻1例；而非脫位側膝內翻畸形15例,膝外翻畸形1例,差異有統計學意義(x2=18.139,P=0.000).結論 大多數單側髖關節完全脫位患者脫位側患肢長度較非脫位側延長,其中股骨和脛骨均有延長.脫位側齣現膝外翻畸形的髮生率較高,而非脫位側膝內翻的髮生率高.
목적 관찰골격발육성숙적단측발육성관관절완전탈위적환자탈위측하지장도적변화특점급반수슬관절기형적정황.방법 선택201 1년3월지2012년12월인단측관관절완전탈위접수치료차부합납입배제표준적28례환자작위관찰대상,기중남성6례,녀성22례；년령13.4～66.2세,평균29.8세.탈위측위중저위탈위(HartofilakidisⅡ형)17례(60.7％),고위탈위(HartofilakidisⅢ형)11례(39.3％).환자균행참립위쌍하지전장정위X선검사,우X선편상진행쌍측고골급경골절대장도、하지상대장도적측량,병관찰탈위측여비탈위측슬관절기형정황.대고골절대장도、경골절대장도、쌍하지상대장도급쌍측슬외번각채용배대자료t검험진행통계학분석；대슬외번분포규률급불동탈위정도하지상대장도적분포규률채용x2혹교정x2검험.결과 탈위측고골절대장도교비탈위측연장자17례(60.7％),최장연장32.7 mm,평균연장9.5 mm,차이무통계학의의(t=1.328,P=0.197).탈위측경골절대장도교비탈위측연장자21례(75.0％),최장연장10.9 mm,평균연장4.5 mm,차이유통계학의의(t=3.039,P=0.006).탈위측하지상대장도교비탈위측연장자20례(71.4％),최장연장25.0 mm,평균연장9.4 mm,차이유통계학의의(t=2.451,P=0.022).탈위측슬외번각위3.±4°,비탈위측슬외번각위-3°±4°,쌍측대비차이유통계학의의(t=5.642,P=0.000)；기중탈위측슬외번기형12례,슬내번1례；이비탈위측슬내번기형15례,슬외번기형1례,차이유통계학의의(x2=18.139,P=0.000).결론 대다수단측관관절완전탈위환자탈위측환지장도교비탈위측연장,기중고골화경골균유연장.탈위측출현슬외번기형적발생솔교고,이비탈위측슬내번적발생솔고.
Objective To observe the leg length discrepancy and accompanied knee varus/valgus deformity in matured patients with unilateral dislocation of the hip.Methods From March 2011 to December 2012,28 patients who had unilateral dislocation of hip (Hartofilakidis classification Ⅱ 17 cases and Ⅲ 11 cases) were involved in this study.There were 6 male patients and 22 female patients,the age of the patients were 13.4-66.2 years,with mean age of 29.8 years.The standing anteroposterior full leg length X-ray films were obtained.Leg length discrepancy,the length of the femur,the length of the tibia and identified the varus/valgus knee deformities were measured.Statistical analysis was performed.A student's t test for paired samples was done for comparison of the parameters in the same patient between dislocated and undislocated leg,and the x2 test were used to assess valgus and varus knees,leg length discrepancy in high dislocation and low dislocation groups.Results Seventeen (60.7％) cases had longer femur length on the dislocated side than that on the undislocated side (t =1.328,P =0.197),with the maximum lengthening of 32.7 mm and a mean lengthening of 9.5 mm.Twenty-one (75.0％) cases had longer tibia length on the dislocated side (t =3.039,P =0.006),with a maximum lengthening of 10.9 mm and a mean lengthening of 4.5 mm.Twenty (71.4％) cases had longer relative leg length on the dislocated side (t =2.451,P =0.022),with a maximum lengthening of 25.0 mm and a mean lengthening of 9.4 mm.On the dislocated side of the leg,the degree of valgus angle was 3 °± 4°,while on the undislocated side,that was-3 ° ± 4°(t=5.642,P =0.000).On the dislocated side,12 cases (42.9％) were of valgus deformities and 1 case was of varus deformity.On the contralateral side,15 cases of varus deformities (53.6％) and 1 case of valgus deformity were observed(x2 =18.139,P =0.000).Conclusions Most dislocated legs are longer in length than the contralateral side,both femur and tibia have also lengthened accordingly.Many knees on the dislocated side present valgus deformity,half of the knees on the contralateral side present varus deformity.
