成人发育性髋关节发育不良（DDH）股骨近端的三维重建及测量
发布时间：2018-07-24 08:21
【摘要】：背景DDH股骨近端形态变异较大，三维重建技术的成熟为我们提供了一种更加有效的方法进行DDH股骨近端形态的研究。但截止目前，国内外在DDH股骨近端的三维重建测量的研究依然非常匮乏。 目的通过对成人发育性髋关节发育不良（Devlopmental dysplasia of the hip，DDH）股骨近端进行三维重建并测量相关的解剖学参数，，加深对DDH股骨近端解剖变异的三维形态学认识，用以指导术前计划及假体设计。 方法选择2012年1月至2014年12月，我院收治的成人髋关节发育不良患者共38例（47髋）；对照组选择成人健康志愿者31例（31髋）。所有患髋均进行CT扫描和骨盆正位片检查，按照Crowe分型方法进行分型。将获得的髋关节CT数据导入Mimics17.0软件进行重建，测量以下参数：颈干角、头颈长、偏心距、大粗隆高点高度、股骨头高度、峡部高度，峡部内径（Di）、小粗隆最突出点近侧10mm髓腔内径（DT+10）和小粗隆最突出点远侧20mm髓腔内径（DT-20）；计算DT+10/DT-20、DT+10/Di和DT-20/Di的值。应用SPSS19.0软件进行统计分析，对四组之间各参数差异进行方差分析，并对组与组之间的差异性进行多重比较（LSD法）。设定P 0.05为显著性差异指标。 结果正常人、CroweI型、CroweII或III型及CroweIV型的颈干角分别为：131.8±5.9°，131.8±7.1°，131.7±6.5°，122.8±11.4°；正常人、CroweI型、CroweII或III型及CroweIV型头颈长分别为：53.1±4.4mm，48.6±6.7mm，50.4±4.7mm，44.6±6.6mm；正常人、CroweI型、CroweII或III型及CroweIV型偏心距分别为：39±4.3mm，35.8±5.8mm，37.3±4.2mm，36.1±4.3mm；正常人、CroweI型、CroweII或III型及CroweIV型DT+10分别为：24.6±2.5mm，25.2±3.4mm，21.9±4.2mm，17.2±5.3mm；正常人、CroweI型、CroweII或III型及CroweIV型DT-20分别为：17.1±2.3mm，17.1±2.3mm，16.3±3.2mm，12.2±3mm；正常人、CroweI型、CroweII或III型及CroweIV型Di分别为：10.1±1.4mm，9.9±2.2mm，8.3±1.8mm，8.7±1.7mm；正常人、CroweI型、CroweII或III型及CroweIV型大粗隆高点高度分别为：6.1±3.9mm，8.9±7.2mm，7.5±3.3mm，12.1±6.1mm；正常人、CroweI型、CroweII或III型及CroweIV型股骨头高度分别为：46.5±6.2mm，39.6±6.5mm，39.1±4.2mm，38.8±8.6mm；正常人、CroweI型、CroweII或III型及CroweIV型峡部高度分别为：116.5±10.6mm，106.2±13.8mm，108.8±10.5mm，94.1±19.7mm；正常人、CroweI型、CroweII或III型及CroweIV型DT+10/DT-20分别为：1.5±0.2，1.5±0.2，1.4±0.3，1.4±0.2；正常人、CroweI型、CroweII或III型及CroweIV型DT+10/Di分别为：2.5±0.4，2.6±0.5，2.7±0.6，2±0.4；正常人、CroweI型、CroweII或III型及CroweIV型DT-20/Di分别为：1.7±0.2，1.8±0.3，1.9±0.3，1.4±0.2。 Crowe I-III型DDH颈干角与正常人无明显差异，Crowe IV型DDH颈干角显著小于正常人和Crowe I-III型DDH；Crowe IV型DDH头颈长显著小于Crowe I-III型DDH；Di在正常人和Crowe I型间无显著差异，Crowe II-III型和Crowe IV型间无显著差异，但前两者与后两者间存在显著差异；DT+10/DT-20和偏心距在正常人和DDH组及DDH不同组之间无显著的统计学差异；DT+10、DT-20、DT+10/Di及DT-20/Di在Crowe IV型DDH显著小于Crowe I-III型DDH；Crowe IV型DDH大粗隆高点高度显著大于正常人和Crowe I-III型DDH；DDH各组股骨头高度显著小于正常人；CroweIV型峡部高度显著小于正常人和Crowe I-III型DDH。 结论DDH股骨颈干角不大于正常人，相反，Crowe IV型DDH颈干角显著减小；相对于Crowe I-III型DDH，Crowe IV型DDH的髓内和髓外参数变异更显著：大粗隆高点和峡部高度更高，小粗隆水平的近端髓腔缩窄更为显著。
[Abstract]:Background DDH has a large variation in the morphology of the proximal femur. The maturation of the three-dimensional reconstruction technique provides a more effective method for the study of the proximal femur morphology of the DDH. But at present, the study of the three-dimensional reconstruction of the proximal femur at home and abroad is still very scarce at home and abroad.
Objective to reconstruct the proximal femur of the adult developmental hip dysplasia (Devlopmental dysplasia of the hip, DDH) and measure the related anatomical parameters to deepen the three-dimensional morphological understanding of the anatomical variation of the proximal femur of the femur, so as to guide the pre operation plan and the design of the false body.
Methods from January 2012 to December 2014, 38 adult patients with dysplasia of hip joint (47 hips) were treated in our hospital. In the control group, 31 adult healthy volunteers (31 hips) were selected. All the affected hips were examined by CT scan and pelvis orthotopic examination and classified according to the Crowe typing method. The acquired hip CT data were introduced into the Mimics17.0 software. The following parameters were measured: the neck dry angle, head and neck, eccentricity, high trochanter height, femoral head height, isthmus height, isthmus diameter (Di), the proximal 10mm intramedullary diameter (DT+10) and the distal 20mm intramedullary diameter (DT-20) of the most protruding point of the trochanter, and the value of DT+10/DT-20, DT+10/Di and DT-20/Di. Statistical analysis was carried out to analyze the variance of the parameters between the four groups and to compare the differences between the groups and the groups (LSD). The P 0.05 was set as a significant difference index.
Results normal people, type CroweI, CroweII or III and CroweIV type were respectively 131.8 + 5.9 degrees, 131.8 + 7.1 degrees, 131.7 + 6.5 degrees, 122.8 + 11.4 degrees; CroweI, CroweII or III type and CroweIV type head and neck length were respectively 53.1 + 4.4mm, 48.6 + 6.7mm, 50.4 + 4.7MM, 44.6 + 6.6mm. Type V eccentricity is 39 + 4.3mm, 35.8 + 5.8mm, 37.3 + 4.2mm and 36.1 + 4.3mm, and CroweI type, CroweII or III and CroweIV DT+10 respectively are 24.6 +, 25.2 + 3.4mm, 21.9 +, 17.2, respectively: 17.1 +, 17.1 +, 16.3 +, 12.2 + M, normal people, type CroweI, CroweII or III and CroweIV Di were 10.1 + 1.4mm, 9.9 + 2.2mm, 8.3 + 1.8mm, 8.7 + 1.7mm, and normal people, CroweI type, 6.1 +, 8.9 +, 7.5, 12.1, respectively. The head height was 46.5 + 6.2mm, 39.6 + 6.5mm, 39.1 + 4.2mm and 38.8 + 8.6MM, and the normal people were 116.5 + 10.6mm, 106.2 + 13.8mm, 108.8 + 10.5mm, 94.1 + 19.7mm, respectively, and normal people, respectively, 1.5 + 1.4 + 0.2, and normal people, type CroweI, CroweII or III and CroweIV DT+10/Di respectively: 2.5 + 0.4,2.6 + 0.5,2.7 + 0.6,2 + 0.4, and normal people, CroweI, CroweII or III and CroweIV type respectively: 1.7 +
There is no significant difference between the Crowe I-III type DDH neck stem angle and the normal person. The Crowe IV type DDH neck dry angle is significantly smaller than the normal and Crowe I-III DDH, and Crowe IV DDH head and neck length is significantly smaller than that of the normal person. There was no significant difference in DT+10/DT-20 and eccentricity between the normal people and the DDH group and the different DDH groups. DT+10, DT-20, DT+10/Di and DT-20/Di were significantly smaller than those of Crowe I-III type Crowe IV DDH. The height of CroweIV isthmus was significantly less than that of normal persons and Crowe I-III DDH..
Conclusion the femoral neck dry angle of DDH is not greater than that of normal people. On the contrary, the Crowe IV type DDH neck dry angle decreases significantly. Relative to Crowe I-III DDH, the intramedullary and extramedullary parameters of Crowe IV DDH are more significant: the high tuberosity point and the isthmus height are higher, and the proximal intramedullary coarctation of the small trochanter level is more significant.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R681.1
[Abstract]:Background DDH has a large variation in the morphology of the proximal femur. The maturation of the three-dimensional reconstruction technique provides a more effective method for the study of the proximal femur morphology of the DDH. But at present, the study of the three-dimensional reconstruction of the proximal femur at home and abroad is still very scarce at home and abroad.
Objective to reconstruct the proximal femur of the adult developmental hip dysplasia (Devlopmental dysplasia of the hip, DDH) and measure the related anatomical parameters to deepen the three-dimensional morphological understanding of the anatomical variation of the proximal femur of the femur, so as to guide the pre operation plan and the design of the false body.
Methods from January 2012 to December 2014, 38 adult patients with dysplasia of hip joint (47 hips) were treated in our hospital. In the control group, 31 adult healthy volunteers (31 hips) were selected. All the affected hips were examined by CT scan and pelvis orthotopic examination and classified according to the Crowe typing method. The acquired hip CT data were introduced into the Mimics17.0 software. The following parameters were measured: the neck dry angle, head and neck, eccentricity, high trochanter height, femoral head height, isthmus height, isthmus diameter (Di), the proximal 10mm intramedullary diameter (DT+10) and the distal 20mm intramedullary diameter (DT-20) of the most protruding point of the trochanter, and the value of DT+10/DT-20, DT+10/Di and DT-20/Di. Statistical analysis was carried out to analyze the variance of the parameters between the four groups and to compare the differences between the groups and the groups (LSD). The P 0.05 was set as a significant difference index.
Results normal people, type CroweI, CroweII or III and CroweIV type were respectively 131.8 + 5.9 degrees, 131.8 + 7.1 degrees, 131.7 + 6.5 degrees, 122.8 + 11.4 degrees; CroweI, CroweII or III type and CroweIV type head and neck length were respectively 53.1 + 4.4mm, 48.6 + 6.7mm, 50.4 + 4.7MM, 44.6 + 6.6mm. Type V eccentricity is 39 + 4.3mm, 35.8 + 5.8mm, 37.3 + 4.2mm and 36.1 + 4.3mm, and CroweI type, CroweII or III and CroweIV DT+10 respectively are 24.6 +, 25.2 + 3.4mm, 21.9 +, 17.2, respectively: 17.1 +, 17.1 +, 16.3 +, 12.2 + M, normal people, type CroweI, CroweII or III and CroweIV Di were 10.1 + 1.4mm, 9.9 + 2.2mm, 8.3 + 1.8mm, 8.7 + 1.7mm, and normal people, CroweI type, 6.1 +, 8.9 +, 7.5, 12.1, respectively. The head height was 46.5 + 6.2mm, 39.6 + 6.5mm, 39.1 + 4.2mm and 38.8 + 8.6MM, and the normal people were 116.5 + 10.6mm, 106.2 + 13.8mm, 108.8 + 10.5mm, 94.1 + 19.7mm, respectively, and normal people, respectively, 1.5 + 1.4 + 0.2, and normal people, type CroweI, CroweII or III and CroweIV DT+10/Di respectively: 2.5 + 0.4,2.6 + 0.5,2.7 + 0.6,2 + 0.4, and normal people, CroweI, CroweII or III and CroweIV type respectively: 1.7 +
There is no significant difference between the Crowe I-III type DDH neck stem angle and the normal person. The Crowe IV type DDH neck dry angle is significantly smaller than the normal and Crowe I-III DDH, and Crowe IV DDH head and neck length is significantly smaller than that of the normal person. There was no significant difference in DT+10/DT-20 and eccentricity between the normal people and the DDH group and the different DDH groups. DT+10, DT-20, DT+10/Di and DT-20/Di were significantly smaller than those of Crowe I-III type Crowe IV DDH. The height of CroweIV isthmus was significantly less than that of normal persons and Crowe I-III DDH..
Conclusion the femoral neck dry angle of DDH is not greater than that of normal people. On the contrary, the Crowe IV type DDH neck dry angle decreases significantly. Relative to Crowe I-III DDH, the intramedullary and extramedullary parameters of Crowe IV DDH are more significant: the high tuberosity point and the isthmus height are higher, and the proximal intramedullary coarctation of the small trochanter level is more significant.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R681.1
【共引文献】
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