发育性髋关节发育不良儿童髋臼形态学病理分型的探讨

Analysis of acetabular morphological pathology types in developmental dysplasia of the hip in children

目的通过三维CT分析髋臼形态学的病理改变,为临床选择合适的骨盆截骨方式提供参考。方法选择101例发育性髋关节发育不良儿童,共129个髋关节。术前行髋关节螺旋CT扫描并通过Mimics 10.01软件进行三维重建,根据以往参考文献分型,结合病例观察,提出髋臼形态学病理分型。结果分为六型:Ⅰ型为轻度发育不良,占31.8%。Ⅱ型为髋臼前上缺损,占17.1%。Ⅲ型为中上缺损,占32.6%。Ⅳ型为全缺损,占10.8%。Ⅴ型为假臼,占5.4%。Ⅵ型为三角型髋臼,占2.3%。结论髋臼形态学新的病理分型有助于对发育性髋关节发育不良儿童病理改变的认识。通过三维CT了解髋臼的不同形态学改变,能为临床选择合适的骨盆截骨方式提供参考。

Objetive provide the useful information for suitable clinical pelvic osteotomy through 3D-CT analysis of acetabular morphological pathology types in developmental dysplasia of the hip in chil- dren. Methods There were 101 patients with developmental dysplasia of the hip of children, a total of 129 hips. Preoperative hip spiral CT scan and three dimensional reconstruction by Mimics 10.01 software were per- formed. According to the type of previous references ,combining with the cases of acetabular morphology observation,we put forward the pathological classification. Results There are six types： type Ⅰ is subtle deficiency,31.8%. Type 1] is anterosuperior deficiency, 17. 1%. Type Ⅲ is midsuperior deficiency,32. 6%. Type Ⅳ is global deficiency,10. 8%. Type Ⅴ is false acetabulum,5.4%. Type Ⅵ is triangle acetabulum,2. 3%. Conclusions The new classification of the different morphology of acetabulum is useful for the tmderstanding of the pathology of developmental dysplasia of the hip in children. The 3D-CT understanding of the changes of dif- ferent morohology of aeetabulum is useful for the choose of suitahle pelvia osteotomv in clinical experience.