成人髋关节发育不良患者股骨髓腔形态研究  

Morphological analysis of the femoral canal in adults with developmental dysplasia of the hip

作　　者：严亮[1] 夏军[1] 黄钢勇[1] 

机构地区：[1]复旦大学附属华山医院骨科,上海200040

出　　处：《国际骨科学杂志》2013年第5期368-370,共3页International Journal of Orthopaedics

基　　金：上海市卫生局青年科研基金(22114y137)

摘　　要：目的探讨成人髋关节发育不良(DDH)患者股骨髓腔CT三维重建的形态差异及临床意义。方法通过CT重建测量72例(78髋)成人DDH股骨与54例(54髋)正常股骨髓腔参数,包括股骨各断面髓腔冠状径、矢状径、最长径、髓腔扭转角、股骨峡部至小转子距离和髓腔张开指数(CFI)。根据Crowe分型标准,DDH患者分为3组,组1为Ⅰ型(23髋),组2为Ⅱ型(31髋),组3为Ⅲ、Ⅳ型(24髋),分别比较3组股骨髓腔参数与正常对照组的差异。结果组1、组3股骨髓腔参数在不同横断面与正常股骨均有差异(P<0.05),组1 CFI(3.94±0.56)较正常对照组(4.53±0.65)小(P<0.05),组2股骨髓腔参数与对照组差异无统计学意义(P>0.05),DDH患者股骨髓腔异常不随髋脱位程度增加而增加。结论 DDH患者股骨髓腔存在异常形态,全髋关节置换术前采用CT重建髋关节评价股骨形态,对手术有指导意义。Objective To explore the anatomy and clinical significance of the femoral canal with developmental dysplasia of the hip （DDH） by reconstruction of computed tomographic （CT） scans.Methods CT scans were obtained from 72 adults （78hips） with DDH and 54 healthy controls （54 hips）.Morphometric parameters of the femur including coronal view canal width,sagittal view canal width,longest canal width,canal rotation,distance from lesser trochanter to canal isthmus and canal flare index （CFI） were derived from CT reconstructions.DDH hips were divided into three groups according to the Crowe classification,group 1：23 hips with Crowe Ⅰ,group 2：31 hips with Crowe Ⅱ,group 3：24 hips with Crowe Ⅲ and Ⅳ,.These anatomical parameters were investigated between three groups and the controls.Results Compared with normal fenmurs,group 1 and group 3 femurs were abnormal in many cross sections,group 1 femurs had smaller CFI （3.94 ±＋ 0.56 versus 4.53 ＋ 0.65,P＜0.05）,the difference of group 2 has no statistical significance （P＞0.05）,the shape of the DDH femoral canal did not become more abnormal with increasing subluxation.Conclusions The shape of dysplastic femurs are abnormal,and the preoperative CT evaluation of hip in DDH patients is necessary,it can provide valuable information for total hip arthroplasty.

关 键 词：髋关节发育不良 形态学 股骨 成人 CT 

分 类 号：R684[医药卫生—骨科学]