The three-dimensional shape of the dysplastic femur
The three-dimensional shape of the dysplastic femur
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DOI：
10.3097/01.blo.0000096819.67494.32
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发表时间：
2003-12-01
影响因子：
4.2
通讯作者：
Paravic, V
中科院分区：
文献类型：
--
作者：
Noble, PC;Kamaric, E;Paravic, V
本研究评估了先天性髋关节发育不良（CDH）与健康对照组相比，股骨的三维解剖结构。计算机断层扫描获得了207名妇女（154例发育不良，53名健康对照），平均年龄为51.6岁（范围，1882年）。大多数发育不良关节被归类为Crowe I（43%）或Crowe II或III（48%），其中9%为Crowe IV。通过CT扫描重建生成股骨的个性化三维计算机模型。通过计算机分析每个股骨重建的尺寸和形态参数。与对照组相比，发育不良的股骨颈更短，股骨管更小、更直。随着半脱位程度的增加，椎管形态也越来越不正常。详细分析表明，股骨发育不良的主要畸形是旋转，根据髋关节半脱位的程度，前倾角增加5 °至16 °。发育不良股骨的旋转畸形发生在小转子和峡部之间的骨干内，不能归因于干骺端的扭转畸形。这项研究表明，有一个显着的差异，正常股骨和CDH的几何形状，即使在轻度病例。在CDH病例中，我们建议使用组配式或特殊设计的组件来适应发育不良的椎管形状。
This study evaluates the three-dimensional anatomy of the femur with congential dysplasia of the hip (CDH) in comparison with healthy controls. Computed tomographic scans were obtained from 207 women (154 with dysplasia; 53 healthy controls) with an average age of 51.6 years (range, 1882 years). Most of the dysplastic joints were classified as Crowe I (43%), or Crowe II or III (48%), with 9% Crowe IV. Individualized three-dimensional computer models of the femur were generated by reconstruction of the CT scans. Dimensional and morphometric parameters were derived by computer analysis of each of the femoral reconstructions. The dysplastic femurs had shorter necks and smaller, straighter 'canals than the controls. The shape,of the canal became more abnormal with increasing subluxation. Detailed analysis showed that the primary deformity of the dysplastic femur is rotational, with an increase in anteversion of 5degrees to 16degrees, depending on the degree of subluxation of the hip. The rotational deformity of the dysplastic femur arises within the diaphysis between the lesser trochanter and the isthmus and is not attributable to a torsional deformity of the metaphysis. This study shows that there is a significant difference in the geometry of the normal femurs and those with CDH, even in mild cases. In CDH cases, we recommend the use of modular or specially designed components to accommodate the shape of the dysplastic canal.