坐骨股骨撞击综合征患者髋部三维CT模型的动态测量分析
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山东第一医科大学附属济南人民医院

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Dynamic measurement and analysis of three-dimensional CT model of hip in patients with ischiofemoral impingement syndrome
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Jinan people''s Hospital Affiliated to Shandong First Medical University

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    摘要:

    摘要 目的 采用三维CT模型的测量方法,分析股骨坐骨撞击综合征患者髋部相关参数及股骨一坐骨间隙动态变化,为临床正确评价提供参考。 方法 选择2018年1月—2019-12月我院骨科检查符合坐骨股骨撞击综合征的17例(29髋)患者为观察组,同期髋关节MRI检查髋关节正常的20例(40髋)患者为对照组。 将两组患者的CT图像以DICOM格式导入Mimics17.0、Geomagic Studio10.0中,重建骨骼的三维模型,在Solidwork中导入模型组件,以股骨头中心为轴心,模拟外展、内收、后伸、前屈运动。测量坐骨股骨间距、股骨偏心距、颈干角、头颈长、小粗隆高径、前倾角、坐骨间距、坐骨角等。 结果 观察组偏心距、头颈长及前倾角显著小于对照组,差异有统计学意义(P<0.05)。颈干角、小转子高径及坐骨间距显著大于对照组,差异有统计学意义(P<0.05)。观察组坐骨股骨间距均显著小于对照组,差异有统计学意义(P<0.001)。外展、内旋运动可显著增加坐骨股骨间距,而内收、外旋运动会减小坐骨股骨间距。髋关节运动对坐骨股骨间距的影响,观察组小于对照组。结论 股骨前倾角、小粗隆高径增大及头颈长减小是导致坐骨股骨间距减小的主要因素,髋关节外展及内旋有利于增大坐骨股骨间距,缓解股方肌的压力。

    Abstract:

    Abstract Objective To analyze the hip parameters and the dynamic changes of the space between femur and ischium in patients with ischiofemoral impingement syndrome(IFI).Methods From January 2018 to December 2019, 17 patients (29 hips) with IFI were selected as the observation group and 20 patients (40 hips) with normal hip joint as the control group. The CT images of the two groups were imported into Mimics17.0 and Geomagic studio 10.0 in DICOM format, to reconstruct the three-dimensional models , and than the model component was imported into SOLIDWORKto simulate the abduction, adduction, extension and flexion movements with the center of the femoral head as the axis. The ischiofemoral space(IFS), femoral offset, femoral neck angle, femoral neck long axis,lesser trochanter height, anteversion angle, ischial distance and ischial angle were measured.Results The femoral offset, femoral neck long axis and anteversion angle of the observation group were significantly smaller than those of the control group (P < 0.05). The femoral neck angle,less trochanter height and ischial distance were significantly higher than those in the control group (P < 0.05). The IFS in the observation group was significantly smaller than that in the control group (P < 0.001). ④Abduction and internal rotation could significantly increase the IFS,But adduction and external rotation could reduce the IFS. The effect of hip joint movement on the IFS in the observation group was smaller than that in the control group.Conclusion The increase of anteversion angle of femur, the lesser trochanter height and the decrease of the femoral neck long axis were the main factors that lead to the decrease of IFS. Abduction and internal rotation of the hip would be beneficial to increase the IFS and relieve the pressure of quadratus femoris.

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  • 收稿日期:2020-08-05
  • 最后修改日期:2020-08-18
  • 录用日期:2020-08-28
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