成人发育性髋关节脱位股骨解剖参数测量

Femur anatomy measurement for developmental dislocation of hip in adult

目的分析成人发育性髋关节脱位患者股骨髓腔解剖形态参数变化,为临床手术治疗提供理论基础。方法收集DDH病例43例53髋,其中女31例,男12例。采用Crowe分型,其中Ⅰ型20髋(37.7%)、Ⅱ型19髋(35.8%)、Ⅲ型7髋(13.2%)、Ⅳ型7髋(13.2%)。Ⅰ、Ⅱ、Ⅲ、Ⅳ型分别对应Ⅰ、Ⅱ、Ⅲ、Ⅳ组。分别进行下肢全长DR影像学(正侧位)及股骨CT三维重建检查并与正常对照组比较。结果 DDH各组间患者股骨形态相似,股骨峡部平均位于小粗隆下115 mm处。DDH组股骨髓腔宽度明显小于对照组。DDH组髓腔张开指数相似,多表现为锥形髓腔。DDH组股骨头中心高度明显低于对照组。DDH组II型、Ⅲ型、Ⅳ型颈干角和对照组相比明显增大。所有DDH组与对照组相比前倾角变大。结论发育性髋关节脱位患者其股骨髓腔形态变异较大,尤其是CroweⅢ、Ⅳ患者。

Objective To analyse the femur canal anatomy parameters for the developmental dislocation of the hip in adult .Methods 43 cases （53 hips） of the developmental dislocation of the hip were enrolled , including 20 hips of CroweⅠ（ 37.7%） , 19 hips of Crowe Ⅱ（ 35.8%） , seven hips of Crowe Ⅲ（13.2%）, and seven hips of Crowe Ⅳ（13.2%）.The lower limb length was measured by X -ray examination and the femur anatomy was reconstructed by the three -dimensional （3-D） CT.All the data were compared with the normal control group .Results The femoral morphology of the patients in each group with DDH was similar .The location of the femoral isthmus was 115 mm inferior to the lesser trochanter in average .The femoral canal of the DDH patients was much smaller than that of the control group.The femoral canal flare index of the DDH group was similar to each other and the canal was more conical.The height of the femoral head center in the DDH group was much lower than that in the control group.The neck-shaft angle of the Crowe Ⅱ,Ⅲ, andⅣin the DDH group were larger than that in the control group .The anteversion of the femoral neck in the DDH group was larger than that in the control group.Conclusion The femoral canal variation is significant , especially in Crowe Ⅲand Ⅳof DDH.