目的利用3D-CT影像,来探讨发育性髋脱位术后再脱位的髋臼及股骨近段的骨性病理形态改变,以分析术后再脱位的原因,从而指导和改进发育性髓脱位的治疗。方法对28例(28侧)发育性髋脱位术后再脱位患者的3D-CT影像资料进行分析,测量各参数指标,并与38例(51侧)手术成功患者术后值以及正常组对比分析,来探讨术后再脱位的原因。结果术后再脱位组患者的颈干角与正常组和手术成功组比较,均有高度显著性差异,其数值明显增大;术后再脱位组患者髋臼外上缘重型缺损者所占比例,与手术成功组比较有高度显著性差异;术后再脱位组股骨颈前倾角与正常组比较差异有显著性,而与手术成功组比较差异则无显著性。结论术后再脱位原因与股骨颈干角的角度、髋臼外上缘形态、股骨头与髋臼是否恢复同心圆复位关系等密切相关;股骨颈前倾角值比正常组偏大并非导致术后再脱位的必然因素,其术中矫正范围不能完全以正常组为标准,而应当以健侧为标准,纠正到一个比正常组略大的范围。

Objective To investigate and analyze the orthopaedic morphology of re-dislocation after reduction of hop joint dislocation by using 3-dimensional computer tomography.The causes of re-dislocation were analyzed.Methods Twenty-eight cases of developmental dislocation of hip joint with re-dislocation were analyzed by quantitative and qualitative parameter using 3-D CT,and compared with some normal ones.Results The results show that the angle between femoral neck and femoral diaphysis in re-dislocation group were larger than no re-dislocation group and normal one.The incidence of severe deficient of superior acetabulum in re-dislocation group was higher than group with successful operation.The anterior angle of femoral neck was significant difference between re-dislocation and normal group.There was no difference between group of re-dislocation and group with successful operation.Conclusions The causes of re-dislocation of hip joint reduction may be correlated with the angle between femoral neck and femoral diaphysis and the defect of superior acetabulum rim.