Court C, Carlioz H
Hôpital Armand Trousseau, Paris, France.
J Pediatr Orthop. 1997 Jul-Aug;17(4):520-4.
Twenty-two hips in 20 children, all classified as Amstutz type 3 proximal femoral focal deficiency, were studied by means of plain radiographs, arthrograms (30), ultrasound examination (six), computed tomography (CT) scans (including five arthrographies with CT) and magnetic resonance imaging (MRI; nine). These investigations demonstrated that in 15 hips, the superior femoral epiphysis was mobile in the acetabulum, whereas in six others, it was fixed and fused to the acetabulum. In one case, it was impossible to prove whether the epiphysis was mobile or fixed. The key radiologic and other image features that allow these conclusions to be drawn are described. The therapeutic implications are important, as it would be pointless or harmful to attempt to consolidate the femoral neck or put it into valgus when the epiphysis is spontaneously fixed to the acetabulum.
对20名儿童的22个髋关节进行了研究，所有髋关节均被归类为阿姆斯特茨3型近端股骨局限性缺损，研究手段包括X线平片、关节造影（30例）、超声检查（6例）、计算机断层扫描（CT）（包括5例关节造影CT）和磁共振成像（MRI；9例）。这些检查表明，15个髋关节的股骨上端骨骺在髋臼内可活动，而另外6个髋关节的骨骺则固定并与髋臼融合。在1例中，无法确定骨骺是可活动还是固定的。文中描述了得出这些结论的关键放射学及其他影像特征。其治疗意义重大，因为当骨骺自发固定于髋臼时，试图加固股骨颈或将其矫正成外翻是毫无意义或有害的。
