Smith B G, Millis M B, Hey L A, Jaramillo D, Kasser J R
Department of Orthopaedic Surgery, The Children's Hospital and Harvard Medical Medical School, Boston, Massachusetts, USA.
J Pediatr Orthop. 1997 Sep-Oct;17(5):631-6. doi: 10.1097/00004694-199709000-00011.
Computed tomographic (CT) scans were performed after closed reduction of 68 dislocated hips in 53 infants in spica casts with developmental hip dislocation (DDH). Ten measurements were made on the CT scans including acetabular indices and anteversion, hip-abduction angle, lateral and posterior displacement of the femur from the acetabulum, and femoral displacement from a modified Shenton's line drawn from the pubic rami. By using analysis of variance, the correlation of each variable with outcome after reduction was determined, including the development of avascular necrosis or the need for further surgery because of residual dysplasia. None of the variables was predictive of the outcome of persistent hip dysplasia. The subsequent development of avascular necrosis was statistically associated with hip-abduction angles >55 degrees as measured on postreduction CT scans, with 20% of the involved hips developing avascular necrosis on subsequent follow-up.
对53例患有发育性髋关节脱位（DDH）且佩戴髋人字石膏的婴儿的68例脱位髋关节进行闭合复位后，进行了计算机断层扫描（CT）。在CT扫描上进行了10项测量，包括髋臼指数和前倾、髋关节外展角度、股骨头相对于髋臼的外侧和后方移位，以及股骨头相对于从耻骨支绘制的改良Shenton线的移位。通过方差分析，确定了每个变量与复位后结果的相关性，包括无血管性坏死的发生或因残留发育异常而需要进一步手术的情况。没有一个变量能够预测持续性髋关节发育异常的结果。无血管性坏死的后续发生与复位后CT扫描测量的髋关节外展角度>55度在统计学上相关，在后续随访中，20%的受累髋关节发生了无血管性坏死。
