成人单侧髋关节发育不良Crowe分型与骨盆不对称的相关性VIP免费

中华骨科杂志2014年12月第34卷第12期ChinJOrthop,December2014,Vol.34,No.12·1231··髋关节发育不良·成人单侧髋关节发育不良Crowe分型与骨盆不对称的相关性李亚民陈云苏彭晓春程萌旗何文野王加兴【摘要】目的探讨成人单侧髋关节发育不良（developmentaldysplasiaofthehip，DDH）Crowe分型与骨盆不对称的相关性。方法2012年1月至2014年2月收治住院的明确诊断为单侧DDH、年龄＞18岁且有标准骨盆正位X线片的患者100例，男22例，女78例；年龄21~79岁，平均为56.3岁。Crowe分型Ⅰ型30例、Ⅱ型24例、Ⅲ型23例、Ⅳ型23例。测量骨盆正位X线片上健侧及患侧骨盆垂直高度（从坐骨结节到同侧髂嵴最高点的垂直距离），比较健侧及患侧骨盆垂直高度的差异，并分析这种差异与Crowe分型的相关性。结果100例成人单侧DDH患者健侧骨盆垂直高度平均为（23.38±1.46）cm，患侧骨盆垂直高度平均为（22.41±1.38）cm，骨盆垂直高度差平均为（0.98±0.76）cm。CroweⅠ型至CroweⅣ型，健侧骨盆垂直高度分别为（22.88±1.09）cm、（23.23±2.07）cm、（23.75±1.16）cm、（23.79±1.22）cm，患侧骨盆垂直高度分别为（22.70±0.98）cm、（22.41±1.98）cm、（22.47±1.12）cm、（21.92±1.32）cm，骨盆垂直高度差分别为（0.19±0.37）cm、（0.82±0.43）cm、（1.28±0.32）cm、（1.87±0.59）cm，不同分型组患者骨盆垂直高度差的差异有统计学意义。从CroweⅠ型至CroweⅣ型骨盆垂直高度差逐渐增大，骨盆垂直高度差与患侧髋关节脱位程度呈正相关（Y=7.61X-0.124，r=0.819，P=0.000）。结论成人单侧DDH患者存在影像学上的骨盆不对称现象，两侧骨盆垂直高度差的大小与患侧髋关节脱位程度呈正相关。【关键词】髋脱位，先天性；骨盆；成年人【证据等级】治疗性研究Ⅳ级ResearchofthecorrelationbetweenpelvisasymmetryandCroweclassificationofunilateraldevelopmentaldysplasiaofthehipinadultsLiYamin,ChenYunsu,PengXiaochun,ChengMengqi,HeWenye,WangJiaxing.DepartmentofOrthopaedics,ShanghaiSixthPeople'sHospital,ShanghaiJiaotongUniversity,Shanghai200233,China【Abstract】ObjectiveToinvestigatetherelationshipbetweenpelvicasymmetryandCroweclassificationofunilateraldevelopmentaldysplasiaofthehipinadults.MethodsAccordingtotheinclusioncriteria,100casesofunilateralDDHinadultswerecollected,including78femalesand22males,withanaverageageof56.3yearsold(range,21-79years).IntermsofCroweclassification,therewere30casesofCrowetypeⅠ,24casesofCrowetypeⅡ,23casesofCrowetypeⅢ,and23casesofCroweⅣ.Thenormal⁃sideandaffected⁃sidepelvicverticalheight(thedistancefromthehighestpointoftheischialtuberositytotheiliaccrestpeak)weremeasuredviatheradiogramofanteroposteriorpelvis.Furthermore,wecomparedtheaffected⁃sidepelvicverticalheightwiththenormal⁃sideandanalyzedtherelationshipbetweenCroweclassificationandthedifferenceinpelvicverti⁃calheight.ResultsTheaveragepelvicverticalheightwas23.38±1.46cminthenormal⁃sideand22.41±1.38cmintheaffected⁃side.TheaverageD⁃valueofpelvicverticalheightbetweentwosidesis0.98±0.76cm.FromCrowetypeⅠtoⅣ,theaverageheightsofthenormal⁃sidewere22.89±1.09cm,23.23±2.07cm,23.75±1.16cm,23.79±1.22cm,whilethoseoftheaffected⁃sidewere22.70±0.98cm,22.41±1.98cm,22.47±1.12cmand21.92±1.32cm.TheaverageD⁃valuesineachgroupwere0.19±0.37cm,0.82±0.43cm,1.28±0.32cm,1.87±0.59cm.Thedifferencesbetweenthenormal⁃sideandtheaffected⁃sideineachtypewerestatisticallysignificant.TheaverageD⁃valueincreasedsignificantlywithCrowetypeincreased,andtherewasapositivecorrela⁃tionbetweentheD⁃valueofbilateralpelvicverticalheightandthedegreeofhipdislocation.ConclusionThepelvicasymmetrydoesexistinadultpatientswithunilateraldevelopmentaldysplasiaofthehip.Moreover,thea...