论文部分内容阅读
目的：为了探讨发育性髋关节脱位（DDH）的同心复位指标以及股骨头同心复位与否对髋臼发育及其预后的影响。方法：从1980～1992年经闭合复位治疗的486例DDH病例中，选取单髋全脱位Ⅱ°者38例，测量其复位前后股骨颈前倾角、颈干角、够日指数（AI）、相对髋臼指数（AAI）及Y－Coordinate指数，并将Y－Coordinate指数与复位结果作对比研究。结果：健髋Y－Coordinate指数95％正常值范围为0．69～0．85。复位前同心复位组与非同心复位组比较，AI差异有显著性，但股骨颈前倾角、颈干角、AAI差异无显著性；同心复位组，复位后3个月、6个月、9个月与复位前比，以及复位后6个月．9个月与复位后3个月比，AI下降、AAI增高有显著性；非同心复位组，复位后9个月与复位前及复位后3个月比，AI下降有显著性，但AAI增高无显著性。复位后6个月Y-Coordinate指数＞0．85者，1年后均存在半脱位或全脱位；≤0．85者，则复位1年后患髋正常率较高。结论：Y－Coordinate指数≤0．85可以作为股骨头同心复位的指标；股骨颈前倾角、颈干角、AAI可能并非影响股骨头同心复位的主要因素。髋臼自发育高峰时间为复位后6个月内，股骨头非同心复位，则髋臼发育迟缓。
Objective: To investigate the concentric reduction index of developmental dislocation of the hip (DDH) and the effect of concentric reduction of the femoral head on acetabular development and its prognosis. Methods: From 486 cases of DDH treated by closed reduction from 1980 to 1992, 38 patients with total hip dislocation (Ⅱ °) were selected to measure the femoral neck anteversion, neck angle, ankle index (AI) before and after reduction, Acetabular index (AAI) and Y-Coordinate index, and Y-Coordinate index and reset results for comparative study. Results: The normal range of Y-Coordinate index of healthy hip ranged from 0.69 to 0.85. Compared with non-concentric reduction group, there was significant difference in AI between concentric reduction group and non-concentric reduction group, but there was no significant difference in femoral neck anteversion, neck angle and AAI. In concentric reduction group, 9 months Months before and after reset, and 6 months after reset. 9 months and 3 months after the reset, AI decreased, AAI increased significantly; non-concentric reduction group, 9 months after the reset and 3 months after the reset than before, AI decreased significantly, but AAI increased No significant. 6 months after the reset Y-Coordinate index> 0.85, 1 year after the existence of subluxation or total dislocation; ≤ 0.85 were reset to 1 year after the hip with a higher normal rate. CONCLUSION: Y-Coordinate index ≤0.85 can be used as an index of concentric reduction of femoral head. Femoral neck anteversion, neck angle and AAI may not be the main factors influencing the concentric reduction of femoral head. Acetabular self-development peak within 6 months after the reset, non-concentric reduction of the femoral head, the acetabular stunted growth.