成人DDH髋臼影像学研究及临床意义  

Adult DDH acetabular radiographic research and clinical significance

作　　者：许鸿 吕波[2] 曲银娥[3] 高峰[4] 

机构地区：[1]四川省广汉市骨科医院关节外科,四川广汉市618300 [2]四川省人民医院骨科,成都市610072 [3]河北理工大学基础医学院,河北省唐山市063000 [4]四川省什邡市人民医院医学影像中心,618400

出　　处：《临床合理用药杂志》2015年第16期40-41,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的针对四川地区成人发育性髋关节脱位(DDH)患者,探讨髋臼的解剖学形态变异,为临床治疗提供理论依据。方法将19例(22髋)CroweⅣ型成人先天性髋关节脱位患者作为脱位组,选择同期在骨科住院的同龄健康成年人22髋作为对照组。术前行X线及CT+三维重建检查,对髋臼的Sharp角和外翻角(ACV),改良髋臼指数(AAI),前后径和上下径,前壁、内壁和后壁,髋臼深度等进行测量,测量结果与正常对照组对比。结果脱位组的Sharp角、ACV大于对照组,AAI小于对照组,脱位组的ACV、后壁和内侧壁厚度大于对照组,髋臼前壁厚度、前后径、上下径和深度小于对照组,差异均有统计学意义(P<0.05)。结论成人DDH行全髋关节置换术时应考虑髋臼的解剖形态变异,在真臼处重建,尽量向髋臼后上方扩臼,选择合适或特制的臼杯并正确角度安放。Objective To explore the acetabulum anatomic variation for adult DDH patients in Sichuan Province ,pro-viding theoretical basis for clinical treatment .Methods Selected 19 patients （ 22 hips ） Crowe Ⅳtype of adult patients with congenital dislocation of hip as dislocation group .Selected the same period in the orthopedics hospital healthy adults 22 hips as control group.Before surgery conducted X-ray and CT＋3D reconstruction.Measured the valgus angle（ACV） and sharp angles of acetabulum,improved acetabular index（AAI）,anteroposterior diameter and vertical diameter ,front wall,the inner wall and the rear wall ,acetabular depth ,compared the measurement results with the normal control group .Results The Sharp angle and ACV of dislocation group were larger than control group ,AAI were lower than control group;the ACV,rear wall and inside wall thickness of dislocation group were greater than control group ,the acetabular front wall thickness ,posterior diameter ,bottom di-ameter and depth of dislocation group were less than control group ,the differences were there was statistically significant （ P〈0.05）.Conclusion While doing THA of Adult high DDH,its anatomical morphological variation must be fully taken into ac-count,rebuild in true acetabulum position ,and do as far as possible to enlarge the postacetabular top ,select the correct cup or tailor-made prosthesis and fix with the appropriate angle .

关 键 词：发育性髋关节脱位 影像学测量 全髋置换术 

分 类 号：R687.4[医药卫生—骨科学]