Li Ya-Min, Li Jue-Hong, Li Bin, Wang Jia-Xing, Chen Yun-Su
Department of Orthopedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China. E-mail.
Saudi Med J. 2016 Dec;37(12):1344-1349. doi: 10.15537/smj.2016.12.15945.
To investigate whether adult patients with unilateral developmental dysplasia of the hip (UDDH) have pelvic asymmetry and what correlation existing between them. Methods: A total of 100 adult patients with UDDH were enrolled in the retrospective observational study in Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China, between January 2012 and February 2014. The anteroposterior pelvic radiographs were reviewed and the pelvic heights and ischium heights were measured and compared between the affected and non-affected sides to find out the relationship between the pelvic morphology and hip dysplasia. Results: The pelvic heights demonstrated significant differences between the non-affected side and the affected side in patients with Crowe type II-IV UDDH (p less than 0.05), but not in patients with Crowe type I UDDH (p=0.09). There were significant differences in the bilateral ischium heights in patients with Crowe type III and IV UDDH (p less than 0.05), but not in patients with Crowe type I and II UDDH (p=0.78, p=0.055). In addition, the degree of hip dysplasia was positively associated with the degrees of asymmetry of pelvis (r=0.78, p less than 0.001) and ischium (r=0.72, p less than 0.001) in UDDH patients. Conclusion: The pelvic asymmetry exists in adult patients with UDDH. In addition, the degree of asymmetry has correlation with the degree of hip dysplasia. We recommend that it should be taken more cautions to use teardrops and ischial tuberosity as anatomy landmarks to balance leg-length discrepancy for unilateral DDH patients in preoperative planning and total hip arthroplasty.
探讨成年单侧发育性髋关节发育不良（UDDH）患者是否存在骨盆不对称及其之间的相关性。方法：2012年1月至2014年2月，在上海交通大学附属第六人民医院对100例成年UDDH患者进行回顾性观察研究。回顾骨盆前后位X线片，测量并比较患侧与非患侧的骨盆高度和坐骨高度，以了解骨盆形态与髋关节发育不良之间的关系。结果：Crowe II-IV型UDDH患者非患侧与患侧的骨盆高度存在显著差异（p<0.05），而Crowe I型UDDH患者无显著差异（p=0.09）。Crowe III型和IV型UDDH患者双侧坐骨高度存在显著差异（p<0.05），而Crowe I型和II型UDDH患者无显著差异（p=0.78，p=0.055）。此外，UDDH患者髋关节发育不良程度与骨盆不对称程度（r=0.78，p<0.001）和坐骨不对称程度（r=0.72，p<0.001）呈正相关。结论：成年UDDH患者存在骨盆不对称。此外，不对称程度与髋关节发育不良程度相关。我们建议，在术前规划和全髋关节置换术中，对于单侧DDH患者，以泪滴和坐骨结节作为解剖标志来平衡肢体长度差异时应更加谨慎。
