| 成人发育性髋关节发育不良患者股骨滋养动脉的X线影像学特点 |
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| 引用本文： | 周阳升,梁笃,杨敏之,孔祥朋,郭人文,曹正,吴东,柴伟. 成人发育性髋关节发育不良患者股骨滋养动脉的X线影像学特点[J]. 中华解剖与临床杂志, 2020, 25(1): 26-30. DOI: 10.3760/cma.j.issn.2095-7041.2020.01.005 |
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| 作者姓名： | 周阳升 梁笃 杨敏之 孔祥朋 郭人文 曹正 吴东 柴伟 |
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| 作者单位： | 1广州市正骨医院髋关节科 510000;2解放军总医院第一医学中心骨科四病区,北京 100089;3南开大学医学院临床医学系,天津 300071 |
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| 摘 要： | 目的 探讨成人发育性髋关节发育不良(DDH)患者股骨滋养动脉的X线影像学特点,为临床避免骨折误诊提供一定帮助。方法 回顾性分析解放军总医院第一医学中心2016年1月—2018年12月就诊的成人DDH患者髋关节X线片(含下肢全长)资料,163例共244髋,男20例、女143例,年龄 20~69(42±16.14)岁, CroweⅠ型72髋、Ⅱ型58髋、Ⅲ型46髋、Ⅳ型68髋。统计存在股骨滋养动脉影像的X线片,分别在正侧位X线片上观测其在股骨干内走行的方向、长度(D)以及股骨干全长(L),在侧位X线片上测量滋养动脉影与股骨长轴夹角(α),以及滋养动脉远端距离股骨大转子顶点的距离(d)、进入股骨干的位置比(R=d/L),并进行D、R、α之间的相关性分析。结果 在244 髋的影像学检查中,98髋(40.16%,95%置信区间33.97%~46.36%)可见滋养动脉影。D为1.22~11.08(4.75±2.21)cm;L为38.83~46.88(42.52±1.90)cm。在正位X线片上与股骨内外侧皮质不相交,侧位X线片上自股骨干后侧进入,向近端前方走行,α为8.20°(5.58°, 12.79°);d为10.82~26.82(19.13±4.09)cm;R为0.26~0.60(0.45±0.09)。 R与D、R与α、D与α之间均存在良好相关性(r=0.673,rs=-0.690、-0.680;P值均＜0.01)。结论 成人DDH患者髋关节X线片中股骨滋养动脉影可见率较高,有其固有特点和规律,能为临床工作中骨折线的鉴别提供依据。
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| 关 键 词： | 髋脱位 发育性髋关节发育不良 股骨滋养动脉 X线 骨折 |
| 收稿时间： | 2019-04-25 |
Radiographic characteristics of femur nutrient artery in adult patients with developmental dysplasia of the hip |
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| Zhou Yangsheng,Liang Du,Yang Minzhi,Kong Xiangpeng,Guo Renwen,Cao Zheng,Wu Dong,Chai Wei. Radiographic characteristics of femur nutrient artery in adult patients with developmental dysplasia of the hip[J]. Chinese Journal of Anatomy and Clinics, 2020, 25(1): 26-30. DOI: 10.3760/cma.j.issn.2095-7041.2020.01.005 |
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| Authors: | Zhou Yangsheng Liang Du Yang Minzhi Kong Xiangpeng Guo Renwen Cao Zheng Wu Dong Chai Wei |
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| Affiliation: | 1.Department of Hip Joint, Guangzhou Orthopedic Hospital, Guangzhou 510045,China;2.Department of Orthopaedics, the First Medicine Center of Chinese People's Liberation Army General Hospital, Beijing 100089, China;3.Department of Clinical Medicine, Medicine School of Nankai University, Tianjin 300071, China |
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| Abstract: | Objective To observe the characteristics of adult developmental dysplasia of the hip(DDH)patients'femur nutrient arteries by hip X-rays so as to avoid misdiagnosis of fracture.Methods A total of 163 patients(244 hips)in the Chinese PLA General Hospital with full-leg radiography and hip X-ray film were included from January 2016 to December 2018.There were 20 males and 143 females with an age of 20-69(42±16.14)years old,Crowe typeⅠ72 hips,typeⅡ58 hips,typeⅢ46 hips,and typeⅣ68 hips.The X-ray films with the femur nutrient artery were counted and measured.The arteries'direction and length(D),length of shaft(L),the angle between the vascular and the femoral anatomic line(α),the distance from the distally of artery to the apex of the greater trochanter(d),ratio of the position entering the femoral shaft(R=d/L),were observed on the lateral x-ray film on the lateral radiograph.The correlation between D,R andαwas analyzed.Results The visible percentage of femur nutrient arteries was 40.16%(98 in 244 hips).The D was 1.22-11.08(4.75±2.21)cm;the L was 38.83-46.88(42.52±1.90)cm.In the lateral X-rays,it ran from the posterior side to the front of the femur,the median ofαwas 8.20°(5.58°,12.79°);the d was 10.82-26.82(19.13±4.09)cm;the R was 0.26-0.60(0.45±0.09).A good correlation was found among D,R andα(r=0.673,rs=-0.690,rs=-0.680;all P values<0.01).Conclusions It is common to see the femur nutrient artery in hip X-ray film of DDH patients.Femur nutrient artery has its own characteristics,which could be provided to distinguish it from fracture. |
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| Keywords: | Hip dislocation Developmental dysplasia of the hip Femur nutrient artery X-ray Fracture |
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