【摘要】 目的探讨髋臼发育不良的临床病理演变规律,寻求其早期诊断指标,分析生物力学改变,以提高疗效。方法通过161个髋关节复位后平均7.4年随访,观察其中髋臼发育不良的X线变化。选择髋臼发育不良11髋,进行计算机图像动态分析,观察其横向生长和纵向倾斜速度。收集髋臼发育不良8例,建立有限元模型,进行髋臼应力测试。各组均以正常者为对照。结果髋臼发育不良患儿复位前髋臼指数在39°以上,复位后3年髋臼指数持续在30°以上。在发育过程中,横向生长速度略高于正常,但无纵向向下倾斜之趋势。其髋关节应力是正常的2倍,受力面积减小,集中于髋臼边缘。结论提出髋臼发育不良的早期诊断指标及生物力学特点,选择最佳时期进行手术,以防止骨关节炎的发生。更多还原

【Abstract】 Objective To study the clinical and pathological evolution of the acetabular dysplasia after reduction of dysplasia dislocation of the hip (DDH) and to find early diagnostic index of the acetabular dysplasia and analyse its biomechanics for improving the treatment efficacy. Mothods One hundred and sixty one hips with DDH were followed up for an average of 7.4 years after reduction procedure. The X-ray changes of acetabular dysplasia was observed. The morphological changes in 11 hips with the acetabular dysplasia were dynamically observed by computer imaging including transverse growth and longitudinal oblique speed. A finite element model of 8 cases with the acetabular dysplasia was set up and its biomechanical character was analysed. All groups were compared with normal controls. Results The acetabular index in all cases of acetabular dysplasia before reduction was above 39° and it remained about 30° at 3 year followed up. The transverse growth speed slightly increased than normal group, however, there was no tendency of longitudinal obliquity. The acetabular stress was as 2 times as high as normal and the stress focused on the edge of the acetabulum with a decreased stress area. Conclusion The time selection to perform a reduction operation is crucial to prevent osteoarthritis.更多还原