摘要
目的测量并分析国内先天性髋关节发育不良(developmental dysplasia of the hip,DDH)患者股骨近端形态参数与髓腔内径曲线,为DDH股骨柄设计提供参考依据。方法进行股骨三维重建后,测量并比较分析30名正常人(30髋,男21名,女9名,平均年龄29.4岁)和64名DDH患者(74髋,男12名,女52名,平均年龄45.3岁)股骨近端形态参数和多个高度上髓腔内外径、前后径,建立不同人群的髓腔内径曲线并进行比较分析。结果 DDH患者与正常人群相比,前倾角(26.39°±14.74°vs 15.68°±7.95°)显著较大(P=0.001),颈干角(125.65°±5.73°vs 129.19°±5.80°)、峡部高度[(99.14±14.62) mm vs (110.13±11.73) mm]、髓腔开大指数[(3.63±0.77) vs (4.45±0.79)]、股骨头直径[(44.01±5.75)mm vs (47.26±3.94)mm]和偏心距[(31.80±3.82)mm vs (36.42±4.84)mm]则显著较小(P<0.05)。结合测量所得的髓腔前后径、内外径与所拟合的内径曲线,DDH近端髓腔呈现的特点为内外径变狭窄、前后径向前偏移。在不同分型DDH中,股骨的变形程度随着分型增大愈发严重,CroweⅣ型DDH患者与其他分型间的股骨髓腔形态存在较大差异。结论 DDH患者的平均股骨近端曲线与正常人群存在较大差异,且DDH的不同分型间也存在形态差异。研究结果有助于定量了解DDH患者的股骨近端形态特征,为设计适用于DDH患者的新型股骨柄提供参考依据。
Objective To measure and investigate the anatomical characteristics of the proximal femur canal curves in patients with developmental dysplasia of the hip(DDH),and to provide references for the design of femoral stem of DDH patients.Methods Three-dimensional reconstructions of the proximal femur were conducted from the CT data,and the anatomical morphology characteristics were obtained from 64 patients with DDH(74 hips,12 males,52 females,average age of 45.3 years)and 30 healthy controls(30 hips,21 males,9 females,average age of 29.4 years).Multiple anteroposterior diameter and mediolateral diameter around the lesser trochanter at different heights and the fitting curves of different groups were obtained.Results The femoral neck anteversion angle,neck-shaft angle,height of the isthmus,canal flare index(CFI),femoral head diameter and femoral offset of DDH patients and healthy controls were 26.39°±14.74°and 15.68°±7.95°,125.65°±5.73°and 129.19°±5.80°,(99.14±14.62)mm and(110.13±11.73)mm,3.63±0.77 and 4.45±0.79,(44.01±5.75)mm and(47.26±3.94)mm,(31.80±3.82)mm and(36.42±4.84)mm,respectively.DDH group had the significantly greater femoral neck anteversion angle,and other anatomical morphology characteristics were significantly smaller than the control group.The obtained anteroposterior diameter,mediolateral diameter and the fitting curves showed that DDH group had narrow medullary cavity and forward shifting anteroposterior diameter.In addition,there was a statistical significance between the CroweⅣDDH and other types of DDH,and deformation degree of the femur increased with the increase of DDH type.Conclusions The proximal femur of DDH patients was significantly different from the healthy controls.Moreover,there were significantly morphological differences between different types of DDH.The research findings can be used as quantitative references for understanding the morphological feature of DDH patients and the corresponding design of femoral stem for DDH patients.
作者
危紫翼
张国强
祁昕征
王慧枝
张敏
马新硕
姚杰
郑诚功
WEI Ziyi;ZHANG Guoqiang;QI Xinzheng;WANG Huizhi;ZHANG Min;MA Xinshuo;YAO Jie;CHENG Chengkung(Beijing Advanced Innovation Centre for Biomedical Engineering,Beihang University,Beijing102402,China;Department of Orthopaedic Surgery,Chinese General Hospital of People’s Liberation Army,Beijing100853,China;School of Biological Science and Medical Engineering,Beihang University,Beijing100083,China)
出处
《医用生物力学》
EI
CAS
CSCD
北大核心
2019年第4期417-424,共8页
Journal of Medical Biomechanics
基金
国家科技计划(国家重点研发计划)(210YBXM2016110002)
关键词
先天性髋关节发育不良
股骨柄
解剖形态
股骨近端髓腔
developmental dysplasia of the hip(DDH)
femoral stem
anatomical morphology
proximal femur canal
作者简介
通信作者:郑诚功,教授,E-mail:ckcheng2018@163.com;共同第一作者:危紫翼;共同第一作者:张国强
