摘要
目的利用3DCT影像,来探讨3岁以下幼儿DDH的骨性髋臼病理形态改变,以指导治疗。方法对44例3岁以下单侧DDH患儿的3DCT影像资料进行分析,测量髋臼前外侧缘倾斜角(ALAL)、侧面髋臼上缘倾斜度(LAI)、髋臼前倾角(AA);分析脱位程度与髋臼上缘形态的关系,年龄与髋臼上缘形态的关系。结果ALAL、LAI、AA在正常侧分别为(20.8±4.7)°、(-2.0±4.9)°、(10.0±4.7)°,在异常侧分别为(33.2±5.2)°、(6.6±5.1)°、(18.1±4.5)°,两侧各指标比较差异均有显著性意义(P<0.01);脱位程度与髋臼形态的关系:重型缺损的髋臼上缘,在Ⅰ°、Ⅱ°脱位组中占62.5%,在其他发育不良组中占16.7%(P<0.01);年龄与髋臼形态的关系:重型缺损髋臼上缘在18个月及以上组中占59.3%,在小于18个月组中占35.3%(P<0.01)。结论3DCT能清晰地显示幼儿DDH骨性髋关节的病理形态;脱位程度与髋臼上缘形态密切相关,Ⅰ°、Ⅱ°脱位时,髋臼外上缘严重受损,当独立行走后,这种破坏更为明显;脱位后,髋臼前倾角明显增加,且脱位时间越长,髋臼前倾越明显。
Objective To evaluate the acetabular morphology in children with developmental dislocation of the hip （DDH） by three-dimensional computed tomography （3DCT）. Methods Fortyfour children under 3 years, with unilateral DDH, were analyzed using 3DCT. The quantitative pa- rameters included： anterolateral acetabular lip angle（ALAL）, lateral acetabular inclination（LAI）, acetabular anteversion（AA）. The qualitative observation included the relationship between the pathologic morphology in superior acetabular rim and the location of the femora[ head, the relationship between the pathologic morphology in superior acetabular rim and patients＇ age. Results The ALAL, LAI and AA were 20.8°±4.7°, -2. 0°± 4.9° and 10.0°±4.7° in normal hips, compared with 33.2°±5.2°, 6.6°±5.1° and 18.1°±4.5° in dysplasia hips, respectively （P〈0.01）. The deficient degree in superior acetabular rim significantly related to the location of the femoral head. The incidence of severely deficient acetabulum was 62.5% in group of degree Ⅰ and Ⅱ completely dislocated hips, and only 16.7% in group of other dysplasia hips （P〈0.01）. Moreover, the severely deficient acetabulum was noted in 59.3% of children older than 18 months, compared with only 35.3% in infants younger than 18 months（P〈0.01）. Conclusions 3DCT can demonstrate the details of the pathologic morphology of acetabulum in children with DDH.
出处
《中华小儿外科杂志》
CSCD
北大核心
2005年第11期572-575,共4页
Chinese Journal of Pediatric Surgery
