发育性髋关节脱位闭合复位后髋臼发育的影响因素研究  

Study on factors influencing acetabular development after closed reduction in developmental dislocation of the hip

作　　者：李刚[1] 曾玮[1] 林清坚[2] 黄常红[2] 刘智[1] 

机构地区：[1]平湖市中医院骨伤科,浙江平湖314200 [2]福州市第二医院骨科

出　　处：《中国骨伤》2009年第1期10-13,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨发育性髋关节脱位闭合复位后髋臼发育的影响因素,为提高发育性髋关节脱位闭合复位的疗效提供理论依据。方法:2002年1月至2005年12月,采用闭合复位治疗100例单侧发育性髋关节脱位患儿,测量患侧髋关节在复位后第12个月时的髋臼指数(AI)和髋臼深度与宽度比值[AI(D/W)]。以性别、侧别、年龄、复位前患侧AI、复位前患侧AI(D/W)、脱位程度、股骨头宽度比值、复位前患侧股骨颈前倾角(FNA)、h/b比率及内收肌切断与牵引等10个因素作为自变量,分别以复位后第12个月患侧AI、AI(D/W)作为因变量,进行多重线性逐步回归分析,筛选出主要的影响因素。结果:年龄、性别、脱位程度、h/b比率、股骨头宽度比和复位前患侧FNA对AI、AI(D/W)有明显影响。年龄、脱位程度和复位前患侧FNA与AI成正相关,与AI(D/W)成负相关;股骨头宽度比和h/b比率与AI成负相关,与AI(D/W)成正相关。女性较男性髋臼发育快。结论:年龄、性别、脱位程度、是否同心复位、复位前患侧股骨头发育程度和股骨近端形态是发育性髋关节脱位患儿髋臼发育的主要影响因素。Objective：To explore factors influencing acetabular development after closed reduction in developmental dislocation of the hip （DDH）, to provide theoretical basis for improving the therapeutic effects of closed reduction treatment of DDH. Methods：A total of 100 children with single side DDH who were treated by closed reduction from January 2002 to December 2005 were followed up, and the AI and AI （D/W） of dislocation hip were measured at the 12th month after reduction. Ten factors such as gender, side, age, AI and AI （D/W） of dislocation hip before reduction, degree of dislocation, the rate of width of femoral head, femoral neck anteversion of dislocation hip before reduction, h/b rate, cut off adductor and skeletal traction et al were taken as independent variable ,AI and AI （D/W） at the 12th month after reduction were taken as dependent variable, then multiple linear stepwise regression analysis was used to screen the major influencing factors. Results： Age, gender,degree of dislocation, h/b rate, the rate of width of femoral head and femoral neck anteversion exerted obviously influence on AI and AI （D/W）,and then age,degree of dislocation and FNA had positive correlation with AI and negative correlation with AI （D/W） ;the rate of width of femoral head and h/b rate had negative correlation with AI and positive correlation with AI （D/W）. The development of acetabular of female patients was faster than that of male patients. Conclusion： Age, gender, degree of dislocation, concentric reduction or not, the development degree of femoral head before reduction and proximal femoral shape are the major factors influencing acetabular development.

关 键 词：髋脱位 髋臼 生长和发育 儿童 

分 类 号：R684.7[医药卫生—骨科学] R726.847[医药卫生—外科学]