组织工程与重建外科杂志2024，Vol.20Issue(1)：97-103,7.DOI:10.3969/j.issn.1673-0364.2024.01.010
儿童单侧发育性髋关节脱位双下肢差异统计及其影响因素
Statistics on difference in length of lower limbs and its influencing factors in children with unilateral developmental dislocation of the hip
摘要
Abstract
Objective To measure and analyze the characteristics of the radiographic lower limb differences between the unaffected side and the affected side in children with unilateral developmental dysplasia of the hip(UDDH),including leg length discrepancy(LLD),femoral neck anteversion(FNA)and femoral neck shaft angle(NSA)differences.Methods The clinical imaging data of 120 patients with UDDH who met the inclusion criteria from January 2018 to June 2021 were retrospectively analyzed.According to the Tonnis classification,UDDH is divided into type ⅰ,ⅱ,ⅲ,and ⅳ.The standing position pelvic femoral full-length X-ray and pelvic femoral CT were taken,and the following parameters were measured:Femoral length(FL),greater trochanter femoral length(GTFL),lesser trochanter femoral length(LTFL),metaphysis femoral length(MFL),intertrochanteric distance(ITD),FNA and NSA.The above parameters of the healthy side and the affected side were compared,and the difference between the healthy and affected sides of each parameter was calculated.The number of cases in which the healthy side of the above parameters was longer or shorter than the affected side was counted respectively.The differences of imaging parameters between healthy and affected sides were compared among different tonnis types,ages and genders.Results The FNA,NSA,MFL,and LTFL on the affected side were larger than those on the healthy side,and the differences were statistically significant(P＜0.05);On the contrary,the FL,GTFL,and ITD on the healthy side were larger than those on the affected side,and the differences were statistically significant(P＜0.05).In FNA,NSA,LTFL,and MFL,the larger(longer)constituent ratio of the affected side was greater than those of the healthy side,and the longer constitutive ratio of the healthy side was greater than those of the affected side in FL,GTFL,and ITD.According to the multiple linear regression statistics of different models,the difference between the NSA and MFL affected side in mod1 decreased with age(P＜0.05),and also statistically significant in mod2 and mod3(P＜0.05).In mod4,5,6,The FL difference between the affected side and the healthy side decreased with the increase of the degree of dislocation,which was statistically significant(P＜0.05).The higher the degree of dislocation,the smaller the FL of the affected side than the healthy side.The NSA difference of the affected side and the healthy side decreased with age,and the NSA of the affected side gradually approached that of the healthy side,or even was smaller than that of the healthy side.Regardless of the degree of dislocation,the MFL of the affected side was larger than the MFL of the healthy side,and the FL of the affected side was smaller than the FL of the healthy side as the degree of dislocation increased.Conclusion The FL of the affected side was shorter than that of the healthy side,but the difference was very small and had no actual clinical significance;While the MFL of the affected side was significantly larger than that of the healthy side,indicating that there was indeed LLD in patients with preoperative UDDH.The FNA and NSA of the affected side increased significantly compared with the healthy side,but the increased value was small,and its clinical significance needs further study.The difference of FNA of the affected side did not decrease with age,and the difference of NSA between the affected side and the healthy side negatively correlated with age.关键词
儿童/单侧发育性髋关节脱位/下肢长度差异/股骨颈前倾角Key words
Children/Unilateral developmental dysplasia of the hip/Leg length discrepancy/Femoral neck anteversion分类
医药卫生引用本文复制引用
李雅琴,谢睿,李论,马娜,周游,康晓鹏..儿童单侧发育性髋关节脱位双下肢差异统计及其影响因素[J].组织工程与重建外科杂志,2024,20(1):97-103,7.基金项目
昆明医科大学研究生创新基金(2023S401) （2023S401）
云南省杨军林专家工作站(33042119850504759). （33042119850504759）
