CAJ | 학술논문

目的：探讨低龄儿童发育性髋关节脱位（ DDH）接受Salter截骨术后的影像学评估效果。方法南方医院创伤骨科2011年3月至2012年8月收治的DDH接受Salter骨盆截骨术治疗的患儿51例，70髋，年龄18～72月龄。患儿于术前和术后第2天摄骨盆正位X线片并影像学测量髋臼指数（ AI）、髋臼倾斜角（ SA）、闭孔角、闭孔高度；并分别于术后3、6、12个月再次摄X线片。术后还测量沈通线、髂骨远端截骨端外移距离比、远端截骨端下压角度。采用配对t检验对手术前后影像学数据进行统计学分析。结果患儿术前AI为35.5°±2.3°，术后为14.6°±1.6°（ P＝0.000）；患儿术前SA为50.6°±3.7°，术后为33.1°±3.2°（P＝0.000）；术前闭孔角为58.3°±3.9°，术后为39.5°±2.8°；术前闭孔高度平均为（1.65±0.26）cm，术后为（1.10±0.14）cm，均改善明显（均P＝0.000）；且随访术后3、6、12个月以上评估指标均有继续下降趋势。术后髂骨远端截骨端外移指数平均为30.1％±3.6％，远端截骨端下压角度平均为31.3°±4.1°。术后有6髋沈通线连续性欠佳，占总数8.57％。结论低龄儿童行Salter截骨术后髋臼及骨盆各影像学评估指标均得到显著改善，且1年内有继续改善趋势；通过对截骨处影像指标的测量为衡量手术的标准提供了数据参考。
목적：탐토저령인동발육성관관절탈위（ DDH）접수Salter절골술후적영상학평고효과。방법남방의원창상골과2011년3월지2012년8월수치적DDH접수Salter골분절골술치료적환인51례，70관，년령18～72월령。환인우술전화술후제2천섭골분정위X선편병영상학측량관구지수（ AI）、관구경사각（ SA）、폐공각、폐공고도；병분별우술후3、6、12개월재차섭X선편。술후환측량침통선、가골원단절골단외이거리비、원단절골단하압각도。채용배대t검험대수술전후영상학수거진행통계학분석。결과환인술전AI위35.5°±2.3°，술후위14.6°±1.6°（ P＝0.000）；환인술전SA위50.6°±3.7°，술후위33.1°±3.2°（P＝0.000）；술전폐공각위58.3°±3.9°，술후위39.5°±2.8°；술전폐공고도평균위（1.65±0.26）cm，술후위（1.10±0.14）cm，균개선명현（균P＝0.000）；차수방술후3、6、12개월이상평고지표균유계속하강추세。술후가골원단절골단외이지수평균위30.1％±3.6％，원단절골단하압각도평균위31.3°±4.1°。술후유6관침통선련속성흠가，점총수8.57％。결론저령인동행Salter절골술후관구급골분각영상학평고지표균득도현저개선，차1년내유계속개선추세；통과대절골처영상지표적측량위형량수술적표준제공료수거삼고。
Objective To evaluate the imaging efficacies after Salter innominate osteotomy for developmental dysplasia of the hip ( DDH).Methods A total of 51 DDH patients with 70 hips were recruited between March 2011 to August 2012.All of them underwent Salter innominate osteotomy.Preoperative radiographs including acetabular index ( AI) , sharp angle ( SA) , obturator angle and obturator height were measured.And postoperative radiographs were taken at 2 days, 3 months, 6 months and 1 year to measure the parameters of AI , sharp acetabular angle , obturator angle , obturator height , shifting index and descending angle of distal iliac end.Paired t test was used for statistical analyses.Results The average correction of AI was 35.5°±2.3°preoperatively versus 14.6°±1.6°postoperatively (P=0.000).The average correction of Sharp angle was 50.6°±3.7°preoperatively versus 33.1°±3.2°postoperatively (P=0.000).The average correction of obturator angle was 58.3°±3.9°preoperatively versus 39.5°±2.8° postoperatively(P=0.000).The average correction of obturator height was (1.65 ±0.26)cm preoperatively versus(1.10 ±0.14) cm postoperatively ( P=0.000).At 3 months, 6 months and 1 year post-operation, the average values of AI , SA, obturator angle and obturator height continued to fall.Both of them showed statistical improvement.Shifting index and descending angle of distal iliac end were 30.1%±3.6% and 31.3°±4.1°on average.Six (8.57%) Shenton lines were bad.Conclusions The imaging evaluations of acetabulum and pelvis show marked improvements until 1 year in DDH patients after Salter innominate osteotomy.It provides data reference for operative evaluations through measuring the imaging parameters of truncation bone.