The Observation Of Femoral Neck Anteversion Of In Children With Development Dislocation Of The Hip By Three-dimensional Computed Tomography

ObjectiveUse three-dimensional CT reconstruction technique to observe the changes of femoralanterior portion dip angle of DDH children, analyze the development law of FNA to guidethe design of treatment scheme.MethodsSelect112cases of DDH children with complete information about three-dimensionalCT reconstruction of femoral anterior portion angle from January2001to December2012in our hospital which includes140sick hip joints.48cases with the DDH on the left,36cases with the DDH on the right,28cases with bilateral DDH; the male26cases, thefemale86cases, sex ratio was1:3.3, age was from6months to12years old, average agewas37months. Select84cases with unilateral DDH children whose normal hip joints asthe contralateral group,140sick hip joints as the affected group which are divided into4degrees (I o, Ⅱo, Ⅲo,Ⅳo) in accordance with the Tonnis points. At the same time, select10cases of children who were accepted pelvic CT scans due to other diseases (excludingmotor system diseases such as hip joints), a total of20normal hip joints as normal controlgroup, the male14cases, the female6cases, age was from6months to12years old,average age was41months, which were divided into6groups according to age:0-1,2hips;1-2,4hips;2-3,4hips;3-4,4hips;4-6,3hips;6-12,3hips. Adopt SIEMENS Sensation128layer CT machine to scan, application Syngo software package for surface shadeddisplay(SSD), multiplanar reconstruction (MPR) and femoral anterior portion angleobservation, data measurement. SPSS12.0statistics software for data analysis. Results1.The normal group(20hips), average FNA was32.87±8.63; the healthy group (84hips), average FNA was39.26±10.15; the affected group(140hips), average FNA was45.56±10.12, the FNA of the healthy side and the affected side of children with DDHincreased obviously compared with the normal group, which had statistical significance (p<0.05).2.140sick hip joints were divided into4degrees according to the Tonnis points, theFNA measurement results of different dislocation degree: Iogroup (n=31), average FNAwas41.66±10.45; IIogroup (n=33), average FNA was46.35±11.66;Ⅲogroup (n=41),average FNA was48.24±6.24;Ⅳogroup(n=35), average FNA was48.46±9.34, whichshowed that FNA increases gradually as the dislocation degree aggravated,Io,IIo,Ⅲo,Ⅳohad significantly statistical differences respectively(P <0.05).3.140hips were divided6groups according to age, calculate FNA mean of each group.The results showed:0.5-1(n=28), average FNA was41.23±8.24;1-2(n=25), averageFNA was36.65±5.23;2-3(n=21), average FNA was39.61±6.27;3-4(n=18), averageFNA was41.11±6.77;4-6(n=22), average FNA was42.54±6.70;6-12(n=26), averageFNA was43.98±9.50, it could be seen that FNA grew relatively fast from1to4years old,became relatively slow after the age of4. Within1year old, average FNA of children was41.23±8.24; average FNA was36.65±5.23at the age of.4.84cases with unilateral DDH children whose healthy hips were grouped accordingto age, calculate FNA mean of each group. The results showed:0.5-1(n=18), average FNAwas35.46±7.68;1-2(n=13), average FNA was33.6±5.18;2-3(n=11), average FNA was34.25±5.35;3-4(n=10), average FNA was35.24±6.51;4-6(n=14), average FNA was36.85±8.67;6-12(n=18), average FNA was37.60±7.14, we could see that FNA grewrelatively fast from1to4years old, became relatively slow after the age of4. Within1year old, average FNA of children was35.46±7.68; average FNA was33.61±5.18at theage of1.5.10cases of normal children with20hips which were grouped according to age,calculate each group FNA mean. The results were:0.5-1(n=2), average FNA was33.26;1-2(n=4), average FNA was31.68;2-3(n=4), average FNA was32.05;3-4(n=4), averageFNA was33.67;4-6(n=3), average FNA was34.43;6-12(n=3), average FNA was34.82,showed that FNA grew relatively fast from1to4years old, became relatively slow afterthe age of4. Within1year old, average FNA of children was35.46±7.68; average FNAwas33.62±5.13at the age of1.6.The FNA of the healthy side, the affected side of children with DDH were increased compared with those of the normal group respectively among different age groups (P <0.05).ConclusionsThe FNA of DDH children were greater than normal ones, the FNA of the affectedside had certain regularity changes as age changed, the FNA decreased as growth anddevelopment before walking independently, and increased as age grew after walkingindependently, but the growth speed became slow gradually. The FNA of the healthy sidesof children with DDH also had a tendency to increase as age grew, but not significantlycompared with the affected sides. The affected sides FNA of DDH children increased asdislocation degree aggravated, former angle changes had some relationships with thedegree of dislocation.