CAJ | 학술논문

目的：探讨成人单侧髋关节发育不良（developmental dysplasia of the hip，DDH）Crowe分型与骨盆不对称的相关性。方法2012年1月至2014年2月收治住院的明确诊断为单侧DDH、年龄＞18岁且有标准骨盆正位X线片的患者100例，男22例，女78例；年龄21~79岁，平均为56.3岁。Crowe分型Ⅰ型30例、Ⅱ型24例、Ⅲ型23例、Ⅳ型23例。测量骨盆正位X线片上健侧及患侧骨盆垂直高度（从坐骨结节到同侧髂嵴最高点的垂直距离），比较健侧及患侧骨盆垂直高度的差异，并分析这种差异与Crowe分型的相关性。结果100例成人单侧DDH患者健侧骨盆垂直高度平均为（23.38±1.46） cm，患侧骨盆垂直高度平均为（22.41±1.38）cm，骨盆垂直高度差平均为（0.98±0.76）cm。CroweⅠ型至CroweⅣ型，健侧骨盆垂直高度分别为（22.88±1.09）cm、（23.23±2.07）cm、（23.75±1.16）cm、（23.79±1.22）cm，患侧骨盆垂直高度分别为（22.70±0.98）cm、（22.41±1.98）cm、（22.47±1.12）cm、（21.92±1.32）cm，骨盆垂直高度差分别为（0.19±0.37）cm、（0.82±0.43）cm、（1.28±0.32）cm、（1.87±0.59）cm，不同分型组患者骨盆垂直高度差的差异有统计学意义。从CroweⅠ型至CroweⅣ型骨盆垂直高度差逐渐增大，骨盆垂直高度差与患侧髋关节脱位程度呈正相关（Y=7.61X-0.124，r=0.819，P=0.000）。结论成人单侧DDH患者存在影像学上的骨盆不对称现象，两侧骨盆垂直高度差的大小与患侧髋关节脱位程度呈正相关。
목적：탐토성인단측관관절발육불량（developmental dysplasia of the hip，DDH）Crowe분형여골분불대칭적상관성。방법2012년1월지2014년2월수치주원적명학진단위단측DDH、년령＞18세차유표준골분정위X선편적환자100례，남22례，녀78례；년령21~79세，평균위56.3세。Crowe분형Ⅰ형30례、Ⅱ형24례、Ⅲ형23례、Ⅳ형23례。측량골분정위X선편상건측급환측골분수직고도（종좌골결절도동측가척최고점적수직거리），비교건측급환측골분수직고도적차이，병분석저충차이여Crowe분형적상관성。결과100례성인단측DDH환자건측골분수직고도평균위（23.38±1.46） cm，환측골분수직고도평균위（22.41±1.38）cm，골분수직고도차평균위（0.98±0.76）cm。CroweⅠ형지CroweⅣ형，건측골분수직고도분별위（22.88±1.09）cm、（23.23±2.07）cm、（23.75±1.16）cm、（23.79±1.22）cm，환측골분수직고도분별위（22.70±0.98）cm、（22.41±1.98）cm、（22.47±1.12）cm、（21.92±1.32）cm，골분수직고도차분별위（0.19±0.37）cm、（0.82±0.43）cm、（1.28±0.32）cm、（1.87±0.59）cm，불동분형조환자골분수직고도차적차이유통계학의의。종CroweⅠ형지CroweⅣ형골분수직고도차축점증대，골분수직고도차여환측관관절탈위정도정정상관（Y=7.61X-0.124，r=0.819，P=0.000）。결론성인단측DDH환자존재영상학상적골분불대칭현상，량측골분수직고도차적대소여환측관관절탈위정도정정상관。
Objective To investigate the relationship between pelvic asymmetry and Crowe classification of unilateral developmental dysplasia of the hip in adults. Methods According to the inclusion criteria, 100 cases of unilateral DDH in adults were collected, including 78 females and 22 males, with an average age of 56.3 years old (range, 21-79 years). In terms of Crowe classification, there were 30 cases of Crowe typeⅠ, 24 cases of Crowe typeⅡ, 23 cases of Crowe typeⅢ, and 23 cases of CroweⅣ. The normal?side and affected?side pelvic vertical height (the distance from the highest point of the ischial tuberosity to the iliac crest peak) were measured via the radiogram of anteroposterior pelvis. Furthermore, we compared the affected?side pelvic vertical height with the normal?side and analyzed the relationship between Crowe classification and the difference in pelvic verti?cal height. Results The average pelvic vertical height was 23.38±1.46 cm in the normal?side and 22.41±1.38 cm in the affected?side. The average D?value of pelvic vertical height between two sides is 0.98 ± 0.76 cm. From Crowe typeⅠto Ⅳ, the average heights of the normal?side were 22.89±1.09 cm, 23.23±2.07 cm, 23.75±1.16 cm, 23.79±1.22 cm, while those of the affected?side were 22.70 ± 0.98 cm, 22.41 ± 1.98 cm, 22.47 ± 1.12 cm and 21.92 ± 1.32 cm. The average D?values in each group were 0.19 ± 0.37 cm, 0.82±0.43 cm, 1.28±0.32 cm, 1.87±0.59 cm. The differences between the normal?side and the affected?side in each type were statistically significant. The average D?value increased significantly with Crowe type increased, and there was a positive correla?tion between the D?value of bilateral pelvic vertical height and the degree of hip dislocation. Conclusion The pelvic asymmetry does exist in adult patients with unilateral developmental dysplasia of the hip. Moreover, the asymmetry has positive correlation with the degree of hip dislocation.