成人高位先天性髋关节脱位临床解剖学研究及应用-外科学专业论文.docx

摘 要 成人高位先天性髋关节脱位临床解剖学研究及应用 研究生：林浩 导师：曹力 副教授 摘 要 目的：探讨成人高位先天性髋关节脱位解剖形态异常，为全髋人工关节置换术 提供解剖学依据。方法：对 1999 年 5 月-2008 年 7 月 49 例 57 髋高度成人先天性髋 关节脱位患者通过术前 X 线、CT 以及外科手术临床观察，测量颈干角、偏心距、股 骨头垂直高度、峡部直径、髓腔闪烁指数、股骨头垂直高度、髋臼前后径， 髋臼后 部厚度，髋臼深径等股骨和髋臼形态学参数，与健侧髋关节进行比较。并术中观察 患髋关节情况。结果：脱位组颈干角 114.20°±3.87°，脱位组偏心距 18.95±2.25mm， 脱位组股骨头垂直高度 40.99±1.81mm，脱位组前倾角 38.53±2.30°，脱位组峡部 107.84±2.89 mm，脱位组髓腔闪烁指数 4.86±0.42，脱位组髋臼前后径 33.02±1.86mm， 脱位组髋臼后部厚度 41.73±1.52mm，脱位组髋臼深径 14.15±0.35mm，测量形态学参 数与健侧比较差别很大，有统计学意义。结论：成人高位先天性髋关节脱位行全髋 人工关节置换术时，应充分考虑其解剖形态学变异，尽量向髋臼的后上方扩臼，避 免过大扩髓造成股骨骨折，并选择合适或特制的假体。 关键词：先天性髋关节脱位；成人； 解剖变异；形态学参数 新疆医科大学医学硕士学位论文 Study and clinical application of mor pho logical anatomical abnormalities of high congenital dislocation of hip in adults Postgraduate: Lin Hao Supervisor: Prof. Cao Li Abstract Objective: To investigate the morphological anatomical abnormalities of high congenital dislocation of hip in adults and provide anatomicial basis for the total hip arthroplasty. Methods: Between May 1997 and July 2008, 57 hips in 49 patients of high congenital dislocation of hip in adults were acquired through Pre-operative X-ray, CT and clinical observation of surgery. These parameters included neck- shaft angle, medial head offset, height of femoral head, anteversion angle,canal flare index, the isthmus, anteroposterior diameter of the true acetabulum, posterior thickness of the true acetabulum,deepth of the true acetabulum. The morphology parameters of femoral and accetabular were measured and were compared with the contralateral hips. The intraoperative situations of hip were observed. Results: The neck-shaft angle was 114.20°±3.87°. The medial head offset was 18.95±2.25mm.The height of femoral head was 40.99±1.81mm. The anteversion angle was 38.53±2.30°. The isthmus was 107.84±2.89mm. The canal flare index was 4.86±0.42. The anteroposterior diameter of the true acetabulum was 33.02±1.86 mm,the posterior thickness of the true acetabulum was 41.73±1.52mm. The deepth of the true acetabulum was 1