中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2013年
11期
834-838
,共5页
贾惊宇%张立军%殷明%程细高%陈伟才%刘希娟%赵群
賈驚宇%張立軍%慇明%程細高%陳偉纔%劉希娟%趙群
가량우%장립군%은명%정세고%진위재%류희연%조군
髋脱位,发育性%股骨颈前倾角%结合前倾角
髖脫位,髮育性%股骨頸前傾角%結閤前傾角
관탈위,발육성%고골경전경각%결합전경각
Hip dislocation,developmental%Femoral neck anteversion angle%Combined anteversion angle
目的 使用3D-CT观察DDH患儿脱位侧髋关节股骨颈是否存在过度前倾,测量分析DDH患儿结合前倾角,并对结合前倾角在股骨去旋转截骨中的作用进行初步探讨.方法 回顾性收集74例单髋脱位DDH患儿的三维CT影像学资料.男14例,女60例.年龄18～48个月,平均22.5个月.左髋受累42例,右髋受累32例,未受累髋74例.所有患儿均测量股骨颈前倾角和结合前倾角.结果 在Ⅰ和Ⅱ度脱位型组,DDH患儿脱位侧髋的股骨颈前倾角和健侧髋之间差异无统计学意义(Ⅰ、Ⅲ度脱位型组脱位侧髋和未脱位髋的股骨颈前倾角分别为32.61°±6.91°和35.45°±7.36°,34.76°±7.11°和32.60°±7.94°;P=0.066,P=0.093).然而在Ⅲ度脱位组,患儿脱位侧髋的股骨颈前倾角明显大于健侧髋,差异有统计学意义(36.37°±9.70°比31.15°±7.72°,P=0.024).脱位侧髋的结合前倾角大于未受累侧髋,差异有统计学意义(51.97°±8.24°比45.14°±8.48°,P =0.001).结论 对Ⅰ和Ⅱ度脱位型组DDH患儿进行股骨去旋转截骨也许并不是必要的,应该慎重考虑.结合前倾角也许可作为指导DDH患儿去旋转截骨的指标.
目的 使用3D-CT觀察DDH患兒脫位側髖關節股骨頸是否存在過度前傾,測量分析DDH患兒結閤前傾角,併對結閤前傾角在股骨去鏇轉截骨中的作用進行初步探討.方法 迴顧性收集74例單髖脫位DDH患兒的三維CT影像學資料.男14例,女60例.年齡18～48箇月,平均22.5箇月.左髖受纍42例,右髖受纍32例,未受纍髖74例.所有患兒均測量股骨頸前傾角和結閤前傾角.結果 在Ⅰ和Ⅱ度脫位型組,DDH患兒脫位側髖的股骨頸前傾角和健側髖之間差異無統計學意義(Ⅰ、Ⅲ度脫位型組脫位側髖和未脫位髖的股骨頸前傾角分彆為32.61°±6.91°和35.45°±7.36°,34.76°±7.11°和32.60°±7.94°;P=0.066,P=0.093).然而在Ⅲ度脫位組,患兒脫位側髖的股骨頸前傾角明顯大于健側髖,差異有統計學意義(36.37°±9.70°比31.15°±7.72°,P=0.024).脫位側髖的結閤前傾角大于未受纍側髖,差異有統計學意義(51.97°±8.24°比45.14°±8.48°,P =0.001).結論 對Ⅰ和Ⅱ度脫位型組DDH患兒進行股骨去鏇轉截骨也許併不是必要的,應該慎重攷慮.結閤前傾角也許可作為指導DDH患兒去鏇轉截骨的指標.
목적 사용3D-CT관찰DDH환인탈위측관관절고골경시부존재과도전경,측량분석DDH환인결합전경각,병대결합전경각재고골거선전절골중적작용진행초보탐토.방법 회고성수집74례단관탈위DDH환인적삼유CT영상학자료.남14례,녀60례.년령18～48개월,평균22.5개월.좌관수루42례,우관수루32례,미수루관74례.소유환인균측량고골경전경각화결합전경각.결과 재Ⅰ화Ⅱ도탈위형조,DDH환인탈위측관적고골경전경각화건측관지간차이무통계학의의(Ⅰ、Ⅲ도탈위형조탈위측관화미탈위관적고골경전경각분별위32.61°±6.91°화35.45°±7.36°,34.76°±7.11°화32.60°±7.94°;P=0.066,P=0.093).연이재Ⅲ도탈위조,환인탈위측관적고골경전경각명현대우건측관,차이유통계학의의(36.37°±9.70°비31.15°±7.72°,P=0.024).탈위측관적결합전경각대우미수루측관,차이유통계학의의(51.97°±8.24°비45.14°±8.48°,P =0.001).결론 대Ⅰ화Ⅱ도탈위형조DDH환인진행고골거선전절골야허병불시필요적,응해신중고필.결합전경각야허가작위지도DDH환인거선전절골적지표.
Objective To observe the femoral neck on dislocated hips presented excessive anteversion in unilateral DDH using 3D-CT.Methods Seventy-four Patients with unilateral dislocation of hip were involved in the study,including 60 females and 14 males with a mean age 22.5 months (range,18-48 months).Left hip was involved in 42 cases,and right hip in 32 cases.Femoral anteversion (FA) and combined anteversion (CA) were measured and compared between the dislocated hips and the uninvolved hips.Results Although no significant difference was observed in FA between 1st and 2nd degree dislocated hips and the uninvolved hips,FA was significantly increased in 3rd dislocated hips when compared with the uninvolved hips (36.37° ± 9.70° vs 31.15° ± 7.72°,P =0.024).The CA was larger in the dislocated hips when compared with the unaffected hips (51.97° ± 8.24° vs 45.14° ± 8.48°,P =0.001).Conclusions Femoral derotational osteotomy seems not to be necessary in 1st and 2nd degree dislocated hips in unilateral DDH.CA may be a more meaningful index for determining the use of femoral de-rotational osteotomy.
