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[婴儿髋臼盂唇]

[The acetabular labrum in infants].

作者信息

Graf R

机构信息

Allgemeines und Orthopädisches Landeskrankenhaus, Stolzalpe.

出版信息

Orthopade. 1998 Oct;27(10):670-4.

PMID:9850971
Abstract

The knowledge of embryology and early development of the hip joint (and especially the "Anlage" of the acetabular labrum) is necessary to correctly understand further growth disturbances and developmental dysplasias and dislocations of the hip joint. "Teratologic" luxations--based on damages of the fetal "Anlage"--should be distinguished from "developing deformations" of originally normal-shaped hip joints. By using modern imaging techniques, especially sonography and MRI, the morphologic relationships of the acetabular labrum in centered and decentered hip joints could be clarified. The tip and the basis of the labrum and their relations with the hyalin-preformed growth zone cartilage of the acetabular roof are changing during the process of decentering and can be clearly visualized by sonographic means. To understand the morphologic changes in decentered hip joints, a clear and consistent terminology should be used: The term "limbus" is misleading and should be avoided; one should use the terms "acetabular labrum" and "hyalin-preformed cartilaginous acetabular roof" for the two histologic subdivisions of the acetabular roof cartilage. We do not know much about size and shape, about nutrition and vascularity of the acetabular labrum, and only few facts about the junction zone of the labral attachment to the hyalin cartilage acetabular roof, and so on. We also do not have any clear evidence about possible micro-damages of the labral-capsular-complex during successful closed reduction and their sequelae in childhood and adolescence, possibly being one cause of labral lesions in adults. Further basic research in this field seems useful and necessary.

摘要

了解髋关节的胚胎学和早期发育(尤其是髋臼唇的“原基”)对于正确理解髋关节进一步的生长紊乱、发育性发育不良和脱位是必要的。基于胎儿“原基”损伤的“致畸性”脱位应与原本形状正常的髋关节的“发育性畸形”区分开来。通过使用现代成像技术,尤其是超声检查和磁共振成像(MRI),可以阐明髋臼唇在中心性和偏心性髋关节中的形态关系。在偏心过程中,髋臼唇的尖端和基部及其与髋臼顶透明预形成生长区软骨的关系会发生变化,并且可以通过超声手段清晰地观察到。为了理解偏心性髋关节的形态变化,应该使用清晰一致的术语:“边缘”一词具有误导性,应避免使用;对于髋臼顶软骨的两个组织学亚部分,应该使用“髋臼唇”和“透明预形成软骨髋臼顶”这两个术语。我们对髋臼唇的大小和形状、营养和血管分布了解不多,关于髋臼唇附着于透明软骨髋臼顶的交界区等方面也只有很少的事实。我们也没有任何明确的证据表明在成功的闭合复位过程中髋臼唇 - 关节囊复合体可能存在的微损伤及其在儿童和青少年时期的后遗症,这可能是成人髋臼唇病变的一个原因。该领域的进一步基础研究似乎是有用且必要的。

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