Department of Paediatric Orthopaedics, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China.
Arch Orthop Trauma Surg. 2012 May;132(5):599-605. doi: 10.1007/s00402-012-1464-0.
Currently, the cover of the femoral head was mainly assessed using conventional plain films after Chiari pelvic osteotomy in most studies. The purpose of the current study was to observe whether the femoral head coverage measured by three-dimensional computed tomography (3D-CT) was consistent with the radiographic findings.
A total of 24 patients (24 hips) with an average age of 11.5 years, underwent Chiari osteotomy due to acetabular dysplasia, and 15 subjects (30 hips) of normal control with a mean age of 12 years were involved in the study. The pre- and postoperative coverage of femoral head was measured by using conventional plain film and 3D-CT on the anterior 1/4, middle 1/2, and posterior 1/4 coronal plane. The anterolateral, mediolateral and posterolateral coverage measured by 3D-CT were compared with the coverage measured by plain radiograph, and which were also compared with the normal control individuals.
The postoperative anterolateral, mediolateral coverage measured by 3D-CT was significantly smaller than that measured by radiography (P < 0.01). No significant difference was found between the 3D-CT measurements on the posterolateral coverage and the radiographic results. The anterolateral femoral head coverage in the patients following Chiari pelvic osteotomy was also smaller than that in the normal control individuals (P = 0.026). In contrast, the postoperative posterolateral coverage in the patients was more excessive than that in the normal control individuals (P = 0.001).
Conventional radiographs may show sufficient cover of the femoral head after Chiari osteotomy, whereas in fact, the cover may be not perfect, especially on the anterolateral part. Therefore, the postoperative 3D-CT is beneficial for evaluating the outcome of Chiari osteotomy, especially when the anterolateral coverage o
目前，在大多数研究中，Chiari 骨盆截骨术后，主要通过常规骨盆平片评估股骨头覆盖情况。本研究旨在观察三维 CT（3D-CT）测量的股骨头覆盖情况是否与影像学结果一致。
共纳入 24 例（24 髋）髋臼发育不良行 Chiari 截骨术的患者（平均年龄 11.5 岁），并纳入 15 例（30 髋）正常对照组的受试者（平均年龄 12 岁）。术前和术后通过常规骨盆平片和冠状面前 1/4、中 1/2、后 1/4 位 3D-CT 测量股骨头覆盖情况。比较 3D-CT 测量的股骨头前外侧、中外侧和后外侧覆盖与平片测量结果，并与正常对照组进行比较。
术后 3D-CT 测量的股骨头前外侧、中外侧覆盖明显小于平片测量值（P<0.01）。3D-CT 测量的股骨头后外侧覆盖与影像学结果无显著差异。Chiari 骨盆截骨术后患者的股骨头前外侧覆盖也小于正常对照组（P=0.026）。相反，术后患者的股骨头后外侧覆盖大于正常对照组（P=0.001）。
常规骨盆平片可能显示 Chiari 截骨术后股骨头有足够的覆盖，但实际上覆盖可能并不完美，尤其是前外侧部分。因此，术后 3D-CT 有利于评估 Chiari 截骨术的效果，尤其是在评估前外侧覆盖情况时。
