关节内侧间隙测量对髋关节脱位术后稳定性的预测

目的探讨关节内侧间隙测量对髋关节脱位术后稳定性的预测意义。方法分析2004～2007年本院10例髋关节再脱位患儿以及随机抽取的50例术后未发生再脱位患儿的影像学资料，对其术后1d、1周、1．5个月、3个月、4个月、5个月、6个月骨盆平片进行患侧髋关节内侧间隙值OA以及泪滴至髋臼外缘的距离OA的测量，并采用D值（D=OA／OA）进行标准化处理。结果无再脱位组D值基本小于0．8。其中30例采用髋关节外展支具，未出现再脱位，D值位于0．66～0．8之间；脱位组在石膏同定期间，D值基本小于0．7，此时股骨头位于髋臼内，未出现脱位；术后6周至3个月拆除石膏后，D值为0．66．0．8，未采取措施，相继出现脱位，此时D值基本大于0．8。结论测量关节内侧间隙对于评价髋关节脱位术后关节的稳定性以及预测早期再脱位有重要意义。D值小于0．66，关节稳定，不会出现再脱位；D值为0．66～0．8，关节稳定性受到影响，可能出现再脱位，需尽早采取干预措施；D值大于0．8，出现再脱位，简单保守治疗措旆失去作用．需再次手术蚕新复位。

To detect the predictive significance of the measurement of the inner joint clearance for the stability of the postoperative hip

Objective To detect the predictive significance of the measurement of the inner joint clearance for the stability of the postoperative hip. Methods We reviewed the imaging data of 10 cases of redislocation and 50 random cases postoperatively between 2004-2007,and measured two values with anterposterior pelvis radiograghs from 1 day,7 days,1.5 months,3 months,4months,5 months,6 months postoperatively, including OA which meant the inner joint clearance of the hip and OA which meant the distance between teardrop and outer edge of acetabulum, then we calculated the D value which amounted to OA divided OA. Results D value of 50 random cases with no redislocation was less than 0.8;30eases of them were prevented from redislocation by using of abducted braceket,D value of which was between 0.66-0.8. and D value of the redislocations was more than 0.8. Conclusions The hip is stable and dislocation doesn＇t occure when D value is less than 0.66.But,when D value is between 0.66 - 0.8,the hip is unstable and redislocation or subluxation occurs inevitably without intervention.However,if simple treatments such as cast or bracket are adopted as soon as possibly,redislocation will be prevented probably.then,when D value is more than 0.8, redislocation occurs consequentially.and reoperation for reduction is required necessarily.As a result,the measurement of inner joint clearance of the postoperative hip plays an important role in evaluation of the stability of the postoperative hip and early redislocation.