术中使用画线法与量角法测量股骨截骨旋转角度的对比分析研究  

Comparative and Analytic Research on two Intraoperative Measuring Methods: Lineation Method and Angular Method of Femoral Neck Anteversion's Correction in Children's Development Dislocation of the Hip

作　　者：沙佳 徐会法[1] 严亚波[1] 李超[1] 黄鲁豫[1] 

机构地区：[1]第四军医大学西京医院骨科,陕西西安710032

出　　处：《现代生物医学进展》2017年第29期5654-5660,共7页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81171735)

摘　　要：目的:探讨应用两种股骨截骨旋转角度测量方法矫正股骨颈前倾角(FNA)在儿童发育性髋关节脱位(DDH)治疗中的价值。方法:回顾性分析我科自2006年1月~2015年6月行手术治疗的DDH 32例(32髋),其中,股骨旋转截骨时,2006年1月~2009年12月的16例(16髋)采用画线法;2010年1月~2015年6月的16例(16髋)采用量角法。术前及术后进行X线及三维CT检查测量FNA。两组的一般资料及术前健侧及患侧FNA角度的差异无统计学意义(P>0.05)。结果:本组病例均获得随访,随访时间12~48个月,平均28个月。两组术后患侧FNA与术前相比,均差异明显(P<0.01);而与健侧相比,差异不明显(P>0.05),说明术后FNA较术前明显改善,达到与健侧大致相等的FNA。两组间术后健侧、患侧FNA比较,无显著性差异(P>0.05),故,目前尚不足以证明行股骨旋转截骨术时后期采用的量角法优于画线法。结论:采用量角法及画线法进行股骨旋转截骨术均可获得满意疗效。Objective： To discuss application of femoral neck anteversion＇s correction, by using the two different measurement during femoral nearly section rotating osteotomy, in the treatment of children＇s development dislocation of the hip. Methods： Between January 2006 and June 2015, according to the X-ray or 3D-CT imaging findings, geometric measurement and the pathological condition in patients, 32 patients （32 hips） with DDH were treated with pelvis osteotomy combined femoral nearly section rotating osteotomy, and the clinical data were retrospectively analyzed. The patients were divided into two groups according to the different intra-operative mea- surement of correction of femoral neck anteversion： 16 patients （16 hips） used the lineation method between January 2006 and December 2009; the others used the angular method between January 2010 and June 2015. Before the operations, FNA index were evaluated by X-ray and thin slice hip joint scan and 3D reconstruction to guide the osteotomy. After the operations, FNA index were rechecked. The general information and preoperative FNA index of affected and unaffected sides of two groups was not statistically significant （P 〉 0.05）. Results： The cases were followed up for 12-48 months （mean, 28 months）. After operations, FNA of the affected side decreased substan-tially, and the FNA, in both groups, had significant difference with themselves before operations （P〈0.01） and had no significant differ- ence with the normal side （P 〉 0.05）. The difference of postoperative FNA index between the group of lineation method and the group of angular method was not statistically significant （P 〉0.05）, suggesting that it is not enough to prove that the angular method of femoral neck anteversion＇s correction was superior to the lineation method. Conclusion： Both lineation method and angular method of femoral neck anteversion＇s correction produce excellent results in pediatric developmental dislocation of the hip.

关 键 词：发育性髋关节脱位 股骨颈前倾角 儿童 手术治疗 三维CT 

分 类 号：R682.17[医药卫生—骨科学]