Burgos J, Gonzalez-Herranz P, Ocete G, Rapariz J M
Servicio de Ortopedia Infantil, Hospital Ramon y Cajal, Madrid, Spain.
J Pediatr Orthop B. 1995;4(2):188-93. doi: 10.1097/01202412-199504020-00011.
We made a radiographic study of 104 unilateral congenital dislocations of the hip (CDH) that had an average age of 12 months (range 4-24), were treated with the same therapeutic protocol, and had an average six years follow-up (range 3-13). Radiographic changes were evident in the proximal femoral epiphysis in 57 hips (55%). In 7 (7%) the changes consisted of central osteoporosis with a cystic aspect, without metaphyseal or physeal changes, and had a normal end result without sequelae. This group was classified as type I. Fifty hips (48%) that were type II showed epiphyseal changes consisting of trabecular rarefaction with osteoporosis and irregular sclerosis, followed by a decrease of epiphyseal height and trabecular recovery. Forty-two hips (40%) were type IIA, with < 75% decrease in epiphyseal height with respect to the healthy side; five of these had a normal evolution, 35 had coxa magna and/or decrease of epiphyseal height, and only two cases had physeal lesion. In type IIB, hips, with > 75% decrease of epiphyseal height, 8 cases (8%) had a final physeal lesion.
我们对104例单侧先天性髋关节脱位（CDH）进行了影像学研究，这些患者的平均年龄为12个月（范围4 - 24个月），采用相同的治疗方案进行治疗，平均随访6年（范围3 - 13年）。57例（55%）髋关节的股骨近端骨骺出现明显的影像学改变。7例（7%）的改变表现为中央骨质疏松伴囊性外观，无干骺端或骨骺改变，最终结果正常，无后遗症。该组被归类为I型。50例（48%）II型髋关节表现为骨骺改变，包括小梁稀疏伴骨质疏松和不规则硬化，随后骨骺高度降低和小梁恢复。42例（40%）为IIA型，相对于健侧，骨骺高度降低<75%；其中5例病情进展正常，35例有大转子增大和/或骨骺高度降低，只有2例有骨骺病变。在IIB型髋关节中，骨骺高度降低>75%，8例（8%）最终出现骨骺病变。
