| Objective:By measuring the unilateral Crowe ??? DDH patients and normal people on the surface of the coronal,sagittal spine-pelvic parameters,comparing two to three,discussion and analysis of unilateral characteristics in patients with Crowe ??? obliquity of pelvis,obliquity of pelvis evaluation three differences at the same time,to guide our hip replacement in the Angle of the acetabulum prosthesis are placed.Methods:A total of 17 patients with unilateral Crowe III DDH,12 patients with unilateral Crowe ? DDH,and 20 normal healthy adults who were admitted to the first affiliated hospital of kunming medical university from October 2017 to October 2019 were included in the study.To the data collected to measure the following parameters:(1)the pelvis coronary:Pelvic tilt(PO)and Sacral slope(SO);(2)the Spinal sagittal parameters:the spine Angle(ST)before and after Thoracic vertebra Angle(TK),Lumbar Lordosis Angle(LL);(3)Pelvic Incidence Angle parameters:Pelvic projection Angle(PI),Sacral Slope Angle(SS),Pelvic Tilt Angle(PT);(4)other Pelvic sagittal parameters:the Sacrum Pelvic Angle(SPI),the pelvic femoral angle(PFA),the Sacrum femur Angle(SFA).ANOVA test was used to analyze the differences of coronal plane and sagittal plane parameters between groups.Results:1.General situation:there were no statistically significant differences in age and gender distribution between the two groups2.Parameter measurement results:(1)measurement results of pelvic coronal parameters(PO,SO):The measurement results showed that the individual variation of pelvic tilt and sacrum tilt was large in patients with unilateral Crowe ? and ? DDH,and the pelvic tilt was consistent with that of the sacrum.The results showed that the absolute values of pelvic tilt(PO)and sacrum tilt(SO)in the Crowe III DDH group were larger than those in the Crowe ? DDH(7.79±3.33)and sacrum tilt(7.68±3.34),and were also larger than those in the normal control group(3.68±3.21)and sacrum tilt(3.77±2.92).(2)spinal sagittal parameters(ST,TK,LL)measurement results:Compared with Crowe ? DDH patients group(86.16±2.06)and the group of healthy adults(86.9±2.59),the spinal rake Angle(82.70±4.12)was decreased in patients with unilateral Crowe III DDH.The posterior thoracic protrusion Angle(19.90±3.73)and lumbar lordosis Angle(33.90±2.99)were decreased in patients with unilateral Crowe III DDH,and were smaller than those in patients with unilateral Crowe IV DDH(22.09±3.18)and lumbar lordosis Angle(35.91±3.19),and smaller than those in healthy adults(25.25±4.15)and lumbar lordosis Angle(44.40±3.38).(3)pelvic incidence Angle(PI,PT,SS)parameter measurement results:The pelvic projection Angle(PI)parameter(54.41±1.63)in the unilateral Crowe III DDH group was slightly larger than that in the Crowe ? DDH group(54.26±1.71),but the pelvic projection Angle(PI)parameter in the patients with Crowe ? and ?DDH was significantly larger than that in the control group of healthy adults(52.66±4.31).However,the sacral tilt Angle(SS)parameters(45.20±2.06)and pelvic tilt Angle(16.5 8±1.19)in the Crowe ? DDH group were larger than those in the Crowe III DDH group(42.99±1.77)and pelvic tilt Angle(15.87±1.11),and were larger than those in the normal healthy adult control group(39.61±4.37)and(14.14±1.67).At the same time,we found that for normal healthy adults,PI(52.66±4.31)?SS(39.61±4.37)+PT(14.14±1.67).However,the analysis of Crowe ?DDH patients showed that PI(54.41±1.63)<SS(42.99±1.77)+PT(15.87±1.11).Crowe ? DDH patients had PI(54.26±1.71)<SS(45.20±2.06)+PT(16.58±1.19).Therefore,the SS+PT-PI formula was used to calculate the differences among the three groups.SS+PT-PI in Crowe ? DDH group(7.52±2.06)was larger than that in Crowe ? DDH group(7.52±2.06)and normal healthy adult control group(1.09±1.49).The result of the difference is:Crowe ? DDH patients>Crowe ? DDH patients>Group of healthy adults.For the normal control group,the SS+PT-PI fluctuated around the value 0,while the mean difference between the Crowe ? DDH group and the Crowe ? DDH group was greater than 0.At the same time,the difference of Crowe ? DDH patients was larger than that of Crowe III DDH patients.(4)measurement results of other sagittal plane parameters(SPI,PFA,SFA):It was found that SPI in the unilateral Crowe ? DDH group(70.07±2.20)was slightly larger than that in the Crowe ? DDH group(68.14±1.97),and was larger than that in the normal healthy adult control group(66.15±2.65).The parameters of pelvic and femoral Angle(PFA)in the Crowe ? DDH group(12.09±1.59)were also larger than those in the Crowe ? DDH group(10.82±0.77)and the normal healthy adult control group(9.74±1.21).The sacral femoral Angle(SFA)parameter(48.40±2.19)in the DDH patients of Crowe ? group was larger than that in the DDH patients of Crowe ? group(45.28±2.66),and smaller than that in the control group of normal healthy adults(52.10±2.87).The results of SPI,PFA and SFA:normal healthy adult control group>Crowe ? DDH patients group>Crowe ? DDH patients group.Conclusion:The pelvic tilt and sacrum tilt of patients with unilateral Crowe ? DDH were less severe than that of patients with unilateral Crowe ? DDH.The spine of patients with unilateral Crowe ? and ? DDH all presented a forward tilt state,and the spinal changes of patients with unilateral Crowe ? DDH were heavier than those of patients with unilateral Crowe ? DDH.Patients with unilateral Crowe ? and ?DDH presented a forward tilting of the sagittal pelvis,and patients with unilateral Crowe ? DDH had a heavier forward tilting of the pelvis.For patients with unilateral Crowe ? and ? DDH,the tilt Angle of the spine-pelvic coronal plane and the sagittal plane is inconsistent.Therefore,the corresponding patients should not be treated as a whole when undergoing artificial hip replacement,but should be treated differently according to the specific conditions of specific patients. |
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