三维CT在股骨颈前倾角测量中的应用

The Evaluation of Femoral Neck Anteversion by Three-dimensional Computed Tomography

目的利用三维CT测量单侧发育性髋关节脱位（DDH）患儿股骨颈前倾角（FNA）的数值,初步研究单髋脱位患儿的双侧股骨近端发育演变规律。方法收集366例单侧DDH患儿的三维CT图像,按年龄分组：小于18个月组、18个月至3岁组、大于3岁组,测量各年龄组的患侧和健侧FNA的大小,利用统计软件学进行统计学分析,并绘制DDH患儿的FNA-年龄变化曲线图。从而揭示股骨近端的发育演变规律。结果单髋脱位的患侧FNA比健侧平均大1°5°,且差异具有统计学意义（P〈0.05）。小于18个月、18个月至3岁年龄组的患侧和健侧FNA的差异没有统计学意义（P〉0.05）,大于3岁的两侧差异有统计学意义（P〈0.05）。结论单髋脱位的股骨近端病理改变并不仅仅存在于患侧,其健侧也发生改变,且双侧FNA随年龄增大的演变规律是对称的。

Objective To evaluate the femoral neck anteversion （FNA）of patients with unilateral developmental dysplasia of the hip （DDH）and reveal the developmental regularity of the proximal femur. Methods 366 three-dimensional CTs of unilateral DDH patients were categorized into three age groups：〈18 months,18 months-3 years,and 〉3 years. The femoral neck anteversion of both sides were measured and a statistical comparison was performed between them. The line chart showing the relationship of femoral neck anteversion and age was drawn to reveal the developmental regularity of the proximal femur. Results In total,the affected side of unilateral DDH had an femoral neck anteversion 1°5°significantly larger than the unaffected side（P 〈 0.05）. There was no statistical difference between affected and unaffeted sides in age group 〈18 months and 18 months-3 years,while it was significant in age group 〉3 years. Conclusion Pathological changes of the proximal femur were observed not only the affected side in unilateral DDH but also the unaffected side. The FNA symmetrically developed with age older