发育性髋发育不良的三维CT分析

Three-dimensional computed tomographic analysis of developmental dysplasia of hip

目的 确定发育性髋发育不良的髋臼病理类型。方法 利用三维CT重建技术对 54例 (男 1 2例 ,女 42例 ) 76髋的前面、后面及侧面观图像进行分析 ,其中男 1 2例 ,女 42例 ,年龄 4个月～ 1 6岁 ,平均年龄 4 .54岁。单纯左侧受累 1 6例 ,左侧受累伴股骨头无菌性坏死者 2例 ,单纯右侧受累者 6例 ,双侧受累者 2 2例 ,双侧受累、对侧进行过手术切开复位者 8例。根据治疗史将患儿分为两组 ,即既往有治疗史组和既往无治疗史组。既往有治疗史组具体又分为手法复位组、手法复位且对侧手术切开复位组、对侧手术切开复位组 ,共三个亚组。比较既往有无治疗史的两组髋关节的髋臼病理类型。结果 确定了三种主要的髋臼病理类型。其中在髋臼边缘缺损类型中 ,发现了 5例后外上缘缺损的亚型。髋臼各病理类型在既往有无治疗史的两组患儿中的分布没有显著差异。结论 既往有无治疗史与髋臼病理类型的分布无关 ,三维CT重建技术对于了解髋臼病理变化 。

Objective To determine pathological typ e of the acetabulum in developmental dysplasia of the hip (DDH). Methods The anterior, posterior and lateral images of hip in 54 patients (male 12, female 42) with DDH (76 hips) were analyzed using 3D-CT reconstructive technique. The mean age was 4.54 years (4 months～16 years). There were included the left hip (14), left hip with aseptic necrosis o f femoral head (2), right hip (6), bilateral hips (22) and bilateral with open r eduction on opposite side ( 8) . All cases were divided into operative group and non-operative group. The former were subdivided into three groups. Results Three principal types were found in this series, which were named as edge defect, maldirection and false acetabulum formation. 5 posteriolateral edge defects was found in DDH. No significant difference existed between the two patient groups. Conclusions Previous treatment did not affect the distrib u tion of pathological type of the acetabulum in DDH. 3-D reconstruction techniqu e is helpful to acquire valuable information in planning strategy of treatment.