Birkenmaier Christof, Jorysz Gabriele, Jansson Volkmar, Heimkes Bernhard
Department of Orthopedic Surgery, Grosshadern Medical Center, University of Munich, Munich, Germany.
J Pediatr Orthop B. 2010 Jan;19(1):1-8. doi: 10.1097/BPB.0b013e32832f5aeb.
The existing studies on the development of the hip joint predominantly focus on either the acetabulum or the proximal femur. This paper investigates the parallel geometrical development of both, the proximal femur and the acetabulum during growth. Six hundred and seventy-five hips with an age from 9 months to 16 years were studied by means of planimetric radiography; angles and lever arms were determined. Although the apophyseal angles remain virtually unchanged throughout growth, the epiphyseal angles and the neck-shaft angle undergo typical changes until the age of 10 years. Subsequently, there are no major changes in the angular conformation of the proximal femur, whereas acetabular coverage and its centric alignment continue to develop further until the end of skeletal growth. The load and muscle lever arms increase until the end of growth with their ratio remaining constant after the age of 10 years. We present correlated data on the geometrical development of the acetabulum and the proximal femur. The interpretation of our findings is to some extent limited by the two-dimensionality of planimetric radiography. Our results do, however, support the timing of corrective osteotomies of the proximal femur relatively soon after the age of 10 years.
现有的关于髋关节发育的研究主要集中在髋臼或股骨近端。本文研究了生长过程中股骨近端和髋臼的平行几何发育情况。通过平面X线摄影对675例年龄在9个月至16岁的髋关节进行了研究；测定了角度和力臂。尽管骨骺角在整个生长过程中几乎保持不变，但骨骺角和颈干角在10岁之前会发生典型变化。随后，股骨近端的角度形态没有重大变化，而髋臼覆盖及其中心对齐在骨骼生长结束前继续进一步发育。负荷和肌肉力臂在生长结束前增加，10岁后它们的比例保持恒定。我们展示了髋臼和股骨近端几何发育的相关数据。我们的研究结果的解释在一定程度上受到平面X线摄影二维性的限制。然而，我们的结果确实支持在10岁后相对较早地进行股骨近端截骨术的时机。
