小儿股骨近端内翻截骨后股骨内翻角度与短缩长度之间的关系

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1、授予单位代码10089学号或申请号20153358中国图书分类号R687.3+1HebeiMedicalUniversity硕士学位论文专业学位小儿股骨近端内翻截骨后股骨内翻角度与短缩长度之间的关系研究生：刘新民导师：韩久卉教授专业：外科学二级学院：第三医院2018年3月目录中文摘要··············································································1英文摘要·····················································

2、·························3研究论文小儿股骨近端内翻截骨后股骨内翻角度与短缩长度之间的关系前言··············································································5材料与方法·····································································5结果·······························································

3、···············7附图··············································································8附表··············································································10讨论··············································································11结论···············

4、·······························································13参考文献········································································13综述····················································································17致谢·············································

5、·······································34个人简历··············································································35中文摘要小儿股骨近端内翻截骨后股骨内翻角度与短缩长度之间的关系摘要目的：探讨发育性髋关节发育不良（developmentaldysplasiaofthehip，DDH）应用小儿髋部锁定加压接骨板(lockingcompressionpediatrichipplate，LCP-PHP)行股骨内翻截骨术，其内

6、翻角度与股骨近端短缩长度之间的关系，并验证我们推导出计算股骨近端短缩长度计算式的可行性。方法：回顾性收集2013年7月至2017年6月在我院收治的55例DDH患儿（55髋）股骨内翻截骨术前和术后即刻髋关节X线片，其中男12例，女43例；年龄2岁～10岁（平均5.6岁）；左侧30例，右侧25例。将X线片导入Digimizer软件采用直接测量法量出每例患儿的术后股骨近端短缩长度值(ΔS)。对手术操作过程进行几何关系分析，推导出股骨近端短缩长度的三角函数计算式为c（sinθ1-sinθ2），c为股骨头中心至股骨截骨近端最内侧点距离、θ1为术前c与截骨线的夹

7、角，θ2为内翻截骨后c与截骨线夹角。通过Digimizer软件测量计算式所需参数，将结果带入推导出的计算式得出股骨近端短缩长度计算式值（ΔS′）。采用配对t检验比较两种方法一般结果，对两种方法进行一致性和相关性分析，验证推导出计算式的可行性。结果：55例DDH患儿直接测量法和计算式计算法内翻截骨后股骨短缩长度分别为:内翻角度<10°短缩长度分别为(1.93±0.82)mm，（1.94±0.81）mm；内翻角度为10°～20°短缩长度分别为(6.11±2.12)mm，（6.16±2.11）mm；内翻角度>20°短缩长度分别为(9.97±2.49)mm，

8、（9.96±2.37）mm。55例DDH患儿术前术后X线片直接测量法和计算式计算法的c和股骨近端短缩长度差异