发育性髋关节脱位中股骨头圆韧带的组织形态学及免疫组化研究
|
摘要
目的:通过对发育性髋关节脱位患儿股骨头圆韧带进行大体形态学、组织学及免疫组织化学研究,探讨发育性髋关节脱位的病理改变及发病机制。
材料和方法:收集我院2005年1月～2006年11月发育性髋关节脱位患儿手术治疗过程中完整切下的股骨头圆韧带标本,共29例36髋(其中2例2髋圆韧带退化),其余27例34髋,年龄9个月～48个月,平均19.8个月;其中<18个月有15例18髋,≥18个月有12例16髋;女性20例25髋,男性7例9髋;单侧脱位20髋,双侧脱位7例14髋;左侧22髋,右侧12髋。
全部标本均进行大体形态学观察、常规组织学染色以及免疫组织化学染色研究,本组采用S-P免疫组化方法检测发育性髋关节脱位各年龄组股骨头圆韧带标本组织中Ⅰ、Ⅲ型胶原蛋白的表达,并结合计算机图像分析系统测定阳性染色面积占目标面积的百分比,半定量比较各组间Ⅰ、Ⅲ型胶原的含量变化。
结果:大体形态学及组织学观察:显示股骨头圆韧带增生、肥大明显,但未见有圆韧带动脉的迹象。其长度为(27.56±4.84)mm,平均宽度为(12.41±2.69)mm,在不同年龄组间、男女不同性别间、左右侧间及单双侧间差别均无统计学意义(P>0.05)。
免疫组化染色:显示Ⅰ型胶原增加明显,阳性面积约占(93.31±3.26)%,Ⅲ型胶原则减少,阳性面积约占(6.59±3.36)%,两者呈负相关关系(r=–0.3480 ,P<0.05),且在不同年龄组间、男女不同性别间差异具有统计学意义(P<0.01),但在左右侧及单双侧之间差异无统计学意义(P>0.05)。
结论:
1.发育性髋关节脱位患儿股骨头圆韧带明显增生、肥大,几乎占据整个髋臼,明显大于正常婴幼儿,接近成人的水平。
2.增生、肥大的圆韧带内未见有圆韧带动脉的存在,只在近髋臼侧可见大量毛细血管增生,近股骨头侧未见有任何血管迹象。
3.发育性髋关节脱位股骨头圆韧带中胶原分布及含量变化明显,胶原含量增多、分布不均、排列紊乱,其中以Ⅰ型胶原增多明显,Ⅲ型胶原则减少。以上胶原纤维的改变与组织器官纤维化、病理性瘢痕性纤维结缔组织增生的改变是一致的。
4.发育性髋关节脱位股骨头圆韧带增生、肥大是一种继发性改变,早期有防止股骨头脱位的作用,晚期失代偿后增生纤维化,反过来阻碍了股骨头的复位或导致缺血性坏死。
Objective: A morphologic, histological and immunohistochemical studies of Ligamentum Capitis Femoris (LCF) in Developmental Dislocation of the Hip (DDH) was designed to investigate the pathology and pathogenesis of formation in DDH.
Materials and Methods: 36 LCF for specimens biopsy were taken during the surgery in 29 patients with 36 hips from January 2005 to November 2006. Two LCF discarded as its degeneration.
Among 34 LCF in 27 patients with 34 hips, the mean age was 19.8 month (range from 9～48 month); 15 patients with 18 hips were younger than 18 month old and 12 patients with 16 hips were beyond; 20 patients with 25 hips were female and 7 patients with 9 hips were male; 20 cases were unilateral DDH and 7 were bilateral; 22 specimens came from left and 12 from right.
All specimens were studied with morphologic observation, histological stain and immunohistochemistry. An immunohistochemical technique (S-P method) was applied to demonstrate the typeⅠ,Ⅲcollagen of the LCF and performed with computer imaging analysis and calculated the positive staining area, then compared the content of collagen change in semiquantitative.
Results: Gross, Morphologic and histological observations: the LCF was hyperplastic, hypertrophia considerably. But there was no artery of ligamentum tere. The length was (27.56±4.84) mm, the average width was (12.41±2.69) mm, There were no statistical significant between the different age groups, different gender groups, left and right groups, unilateral and bilateral groups (P>0.05).
Immunohistochemical stain: the content of collagen typeⅠincreased greatly. Positive staining area was about (93.31±3.26) %, collagen typeⅢdecreased, which was about (6.59±3.36) %, both showed negative correlation (r=–0.3480, P<0.05). There were distinctly statistical significant between the different age groups, different gender groups (P<0.01), but no statistical significant between the left and right groups, unilateral and bilateral groups (P>0.05).
Conclusions:
1. The LCF of patients with DDH was hyperplastic, hypertrophia; almost occupied the whole acetabular which sign was larger than the normal infant and similar to the adult.
2. No artery of ligamentum tere existed in LCF. There were a large number of capillaries increasing in the LCF close to the acetabular, but no blood vessel eyeable in the LCF close to the head of femur which showed the partial hyline degeneration.
3. The distribution and content of collagen of the LCF in DDH changed considerably. The collagen fiber deranged and distributed asymmetric. The content of collagen typeⅠincreased greatly, but collagen typeⅢdecreased. The above change was consistent with the tissue fibrosis and fibroelastosis.
4. The hyperplastic, hypertrophia LCF in DDH was a secondary change. In earlier period it would prevent the dislocation of the femoral head, but late it started decompensation and fibrosis, which hindered the reduction of the head of femur or leaded to avascular necrosis.
材料和方法:收集我院2005年1月～2006年11月发育性髋关节脱位患儿手术治疗过程中完整切下的股骨头圆韧带标本,共29例36髋(其中2例2髋圆韧带退化),其余27例34髋,年龄9个月～48个月,平均19.8个月;其中<18个月有15例18髋,≥18个月有12例16髋;女性20例25髋,男性7例9髋;单侧脱位20髋,双侧脱位7例14髋;左侧22髋,右侧12髋。
全部标本均进行大体形态学观察、常规组织学染色以及免疫组织化学染色研究,本组采用S-P免疫组化方法检测发育性髋关节脱位各年龄组股骨头圆韧带标本组织中Ⅰ、Ⅲ型胶原蛋白的表达,并结合计算机图像分析系统测定阳性染色面积占目标面积的百分比,半定量比较各组间Ⅰ、Ⅲ型胶原的含量变化。
结果:大体形态学及组织学观察:显示股骨头圆韧带增生、肥大明显,但未见有圆韧带动脉的迹象。其长度为(27.56±4.84)mm,平均宽度为(12.41±2.69)mm,在不同年龄组间、男女不同性别间、左右侧间及单双侧间差别均无统计学意义(P>0.05)。
免疫组化染色:显示Ⅰ型胶原增加明显,阳性面积约占(93.31±3.26)%,Ⅲ型胶原则减少,阳性面积约占(6.59±3.36)%,两者呈负相关关系(r=–0.3480 ,P<0.05),且在不同年龄组间、男女不同性别间差异具有统计学意义(P<0.01),但在左右侧及单双侧之间差异无统计学意义(P>0.05)。
结论:
1.发育性髋关节脱位患儿股骨头圆韧带明显增生、肥大,几乎占据整个髋臼,明显大于正常婴幼儿,接近成人的水平。
2.增生、肥大的圆韧带内未见有圆韧带动脉的存在,只在近髋臼侧可见大量毛细血管增生,近股骨头侧未见有任何血管迹象。
3.发育性髋关节脱位股骨头圆韧带中胶原分布及含量变化明显,胶原含量增多、分布不均、排列紊乱,其中以Ⅰ型胶原增多明显,Ⅲ型胶原则减少。以上胶原纤维的改变与组织器官纤维化、病理性瘢痕性纤维结缔组织增生的改变是一致的。
4.发育性髋关节脱位股骨头圆韧带增生、肥大是一种继发性改变,早期有防止股骨头脱位的作用,晚期失代偿后增生纤维化,反过来阻碍了股骨头的复位或导致缺血性坏死。
Objective: A morphologic, histological and immunohistochemical studies of Ligamentum Capitis Femoris (LCF) in Developmental Dislocation of the Hip (DDH) was designed to investigate the pathology and pathogenesis of formation in DDH.
Materials and Methods: 36 LCF for specimens biopsy were taken during the surgery in 29 patients with 36 hips from January 2005 to November 2006. Two LCF discarded as its degeneration.
Among 34 LCF in 27 patients with 34 hips, the mean age was 19.8 month (range from 9～48 month); 15 patients with 18 hips were younger than 18 month old and 12 patients with 16 hips were beyond; 20 patients with 25 hips were female and 7 patients with 9 hips were male; 20 cases were unilateral DDH and 7 were bilateral; 22 specimens came from left and 12 from right.
All specimens were studied with morphologic observation, histological stain and immunohistochemistry. An immunohistochemical technique (S-P method) was applied to demonstrate the typeⅠ,Ⅲcollagen of the LCF and performed with computer imaging analysis and calculated the positive staining area, then compared the content of collagen change in semiquantitative.
Results: Gross, Morphologic and histological observations: the LCF was hyperplastic, hypertrophia considerably. But there was no artery of ligamentum tere. The length was (27.56±4.84) mm, the average width was (12.41±2.69) mm, There were no statistical significant between the different age groups, different gender groups, left and right groups, unilateral and bilateral groups (P>0.05).
Immunohistochemical stain: the content of collagen typeⅠincreased greatly. Positive staining area was about (93.31±3.26) %, collagen typeⅢdecreased, which was about (6.59±3.36) %, both showed negative correlation (r=–0.3480, P<0.05). There were distinctly statistical significant between the different age groups, different gender groups (P<0.01), but no statistical significant between the left and right groups, unilateral and bilateral groups (P>0.05).
Conclusions:
1. The LCF of patients with DDH was hyperplastic, hypertrophia; almost occupied the whole acetabular which sign was larger than the normal infant and similar to the adult.
2. No artery of ligamentum tere existed in LCF. There were a large number of capillaries increasing in the LCF close to the acetabular, but no blood vessel eyeable in the LCF close to the head of femur which showed the partial hyline degeneration.
3. The distribution and content of collagen of the LCF in DDH changed considerably. The collagen fiber deranged and distributed asymmetric. The content of collagen typeⅠincreased greatly, but collagen typeⅢdecreased. The above change was consistent with the tissue fibrosis and fibroelastosis.
4. The hyperplastic, hypertrophia LCF in DDH was a secondary change. In earlier period it would prevent the dislocation of the femoral head, but late it started decompensation and fibrosis, which hindered the reduction of the head of femur or leaded to avascular necrosis.
引文
1. Gray AJ, Villar RN. The ligamentum teres of the hip: An arthroscopic classification of its pathology. Arthroscopy, 1997, 13(5): 575-578.
2. Neverrov VA, Shilnikov VA. A method for forming an artificial ligament for the femur head in endoprosthesis.Vestn Khir Im Grek, 1993, 151(7-12): 81-83.
3. Ponseti IV. Growth and development of the acetabulum in the normal child. J Bone Joint Surg(Am), 1978, 60: 57F.
4. R Wynne-Davies. Familial joint laxity. Proc R Soc Med, Jun 1971, 64(6): 689-690.
5. Estrve, Rafael. Congenital Dislocation of the Hip. A Review and Assessment of Results of Treatment with Special Reference to Frame Reduction as Compared with Manipulative Reduction. J Bone and Joint Surg, 1960, 42-B: 253-263.
6. 吉士俊, 马瑞雪, 阿良, 等.髋臼发育不良的临床演变规律.中华骨科杂志, 2001, 10(21): 609-611.
7. Mari MH, Teeling P, Mann J, et al. Dialated cardiomyopathy is associated with an increase in the typeⅠ, Ⅲ collagen ratio: a quantitative assessment. J Am Cell Cardiol, 1995, 25(6): 1263-1265.
8. Vander Rest M, Garrone R. Collagen family of protein. Faseb J, 1991, 5(13): 2813-2815.
9. Tipton CM, Vailas AC, Matthes RD. Experimental studies on the influences of phyisical activity on ligaments、tendons and joints: a brief review. Acta Med Scand, 1986, Suppl 711: 157.
10. Montes G. Structural biology of the fibres of the collagenous and elastic systems. Cell Biol Int, 1996, 20(1): 15.
11. Chen HH, Li AF, Li KC, et al. Adaptations of ligamentum teres in ischemic necrosis of human femoral head. Clin Orthop, 1996, 328(6): 268-275.
12. Li AF, Li KC, Chen HH, et al. Biomechanical functions of ligatumentum teres. Proceedings 1993 International Society of Biomechanics 14th Congress. Paris, 1993:794-795.
13. Parry D-AD, Craig AS. Collagen Fibrils During Development and Maturation and Their Contribution tothe Mechanical Attributes of Connective Tissue. In Nimni ME(ed). Collagen: Biochemistry and Biomechanics, 1988, 2: 1-22.
14. Ippolito Er, Ishii Yo, Ignacio V. Histologic, Histochemical, and Uitrastructural Studies of the Hip Jiont Capsule and Ligementum Teres in Congenital Dislocation of the Hip. Clin Orthop, 1980, 146: 246-258.
15. 赵东风, 岳勇, 黄耀添, 等.先天性马蹄内翻足深筋膜胶原的免疫组化研究. 中华小儿外科杂志, 2004, 4(25): 182-184.
16. Sakai H, Ko ibuchi N, Ohtake H, et al. Type Ⅰ and type Ⅲprocollagen gene expressions in the early phase of ligament healing in rabbits: an in situhybridization study. J Orthop Res, 2001, 19(1): 132-135.
17. Fuss FK, Bacher A. New aspects of the morphology and function of the human hip joint ligaments. Am J Anatomy, 1991, 192(1): 1-13.
18. Staheli LT, Dion M, Tuell JI. The effect of the inverted limbus onclosed management of congenital hip dislocation. Clin Orthop, 1978, 137: 163-166.
19. Gage JR, Winter RB. Avascular Necrosis of the Capital Femoral Epiphysisas a Complication of Closed Reduction of Congenital Dislocation of the Hip. A Critical Review of Twenty Years’Experience at Gillette Children’s Hospital. J Bone and Joint Surg, 1972, 54-A: 373-388.
20. Walker JM. Growth characteristics of the fetal ligament of the head of femur:significance in congenital hip disease. Yale J Biol Med, 1980, 53(4): 307-316.
21. Lang A, Balint J. Anatomy of ligamentum teres femoris. Acta Morphologica Academiae Scientiarum Hungaricae, 1953, 3(3): 275-285.
22. Weinstein SL. Natural history and treatment outcomes of childhood hip disorders. Clin Orthop, 1997, 344: 227-242.
23. Chi-jeng L, Yung-tai L. Intraoperative Instablility for Developmental Dysplasia of the Hip in Children 12 to 18 Months of Age as a Guide to Salter Osteotomy. J Pediatr Orthop, 2000, 20: no.5.
24. Weathersby HT. The origin of the artery of the ligamentum teres femoris. J Bone Joint Surg[Am], 1959, 41-A, Issue 2: 261-263.
25. Jacques T. Superselective Angiography of the Hip. Radiology, 1977, 124: 648-650.
26. Gautier E, Ganz K, Krugel N, et a1. Anatomy of the medial femoral circum flex artery and its surgical implications. J Bone Joint Surg, 2001, 82(7): 679-683.
27. Fritsch H, Hegemann L.Development of the ligamentum capitis femoris and the artery with the same name. Z Orthop Ihre Grenzgeb, 1991, 129(5): 447-452.
28. Robben SG, Lequin MH, Diepstraten AF, et al. Doppler sonography of the anterior ascending cervical arteries of the hip: evaluation of healthy and painful hips in children. AJR, 2000, 174: 1629.
29. 吉士俊, 马瑞雪, 周永德. 小儿髋关节外科, 第一版. 北京: 人民卫生出版社, 2005, 1(1): 23-24, 48-57.
30. Stuecker RD, Brinker MR, bennett JT, et al. Blood flow to the immature hip. Acta Crthop Scand, 1997, 68: 25.
31. 王海洲, 周伟生. 股骨头血供的研究进展. 影像诊断与介入放射学, 2003, 12(4): 246-249.
32. 苗登顺, 吴永沐. 胎儿和婴儿股骨近端的血供及其临床意义. 中国临床解剖学杂志, 1988, 6(2): 68-71.
33. Lee MC, Eberson CP. Growth and Development of the Child's Hip. Orthop Clin Nort Am, 2006, 37(2): 119-132.
34. Kolodny A. The Architecture and the Blood Supply of the Head and Neck of the Femur and their Importance in the Pathology of Fractures of the Neck. J Bone Joint Surg, 1988, 7: 575.
35. Kalamchi A, MacEwen GD. Avascular necrosis following treatment of congenital dislocation ofthe hip. J Bone Joint Surg [Am], 1980, 62-A: 876-888.
36. Estrve, Rafael. Congenital Dislocation of the Hip. A Review and Assessment of Results of Treatment with Special Reference to Frame Reduction as Compared with Manipulative Reduction. J Bone Joint Surg, 1960, 42-B: 253-263.
37. 马瑞雪, 吉士俊, 刘卫东, 等.粗大圆韧带所致发育性髋脱位复位后股骨头坏死的临床特点.中华小儿外科杂志, 1998, 4-19: 83-85.
38. Salter RB, Kostuik J, Dallas S. Avascular Necrosis of the Femoral Head as a Complication of Treatment for Congenital Dislocation of the Hip in Young Children. A Clinical and Experimental Investigation. Canadian J Surg, 1969, 12: 44-61.
39. Marcin D, Marek S, et al. Avascular necrosis after surgical treatment for developmental dysplasia of the hip. Inter Orthop, 2004, 28: 65-68.
40. Coventry MB, Garcia AV, Mcdonald JR. Vascular changes of the ligamentum teres femoris in disease of the hip. Mayo Clinic Proceedings.1956, 31(22): 599-604.
41. Dunaj W. Microscopic structure of joint capsule, ligamentum teres and joint cartilage of femoral head in congenital dislocation of the hip. Chir Narzadow Ruchu Orthop, 1970, 35: 459.
42. Weiner DS, Hoyt WA, O'Dell HW. Congenital Dislocation of the Hip. The Relationship of Premanipulation Traction and Age to Avascular Necrosis of the Femoral Head. J Bone Joint Surg, 1977, 59-A: 306-311.
43. Howe WW, Lacey T, Schwartz RP. A study of the gross anatomy of the arteries supplying the proximal portion of the femur and acetabulum. J Bone Joint Surg, 1950, 32-A: 856-866.
44. Schink W, Parhofer R. Histological studies on the size of the arteries in the ligamentum capitis femoris. Langenbecks Arch Klin Chir Ver Dtsch Z Chir, 1962, 300: 306-313.
45. Grosso FM, Grasso S. The ligamentum capitis femoris. Comparative anatomical study. Orizzonti Della Ortopedia Odierna e Della Riabilitazione, 1967, 12(1-4): 43-56.
46. Chen HH, Fen-Yau A. Adaptations of Ligamentum Teres in Ischemic Necrosis of Human Femoral Head. Clin Orthop, 1996, 328: 268-275.
47. 赵群, 吉士俊, 周永德. 伸直外展位固定对幼猪股骨头发育的影响. 中华骨科杂志, 1992, 2-15: 101-104.
48. Tange Y, Eida T, Kojo Y. Contribution to the history of development of the ligamentum capitis femoris, including comments on its importance. Yokohama Medical, 1952, 3(3): 151-159.
49. Sanchis M, Zahir A, Freeman MA. The Experlnlental simulation of perthes disease by consecutive interruptions of the blood supply to the capital femoral epiphysls in the puppy. J Bone Joint Surg (Am), 1973, 55: 334-338.
50. Merkle U. On aging changes on the arteries of the ligamentum capitis femoris. Zeitschrift Fur Alternsforschung, 1965, 18(1): 10-12.
51. James J, McCarthy, Peter V, et al. Developmental dysplasia of the hip(DDH). Curr Orthop, 2005, 19(3): 223-230.
1. Harold P, Lehmann, Richard Hinton. Developmental Dysplasia of the Hip Practice Guideline. Pediatrics, 2000, Apr-105: e57.
2. Chii-jeng L, Yung-tai L. Intraoperative Instablility for Developmental Dysplasia of the Hip in Children 12 to 18 Months of Age as a Guide to Salter Osteotomy. J Pediatr Orthop, 2000, vol.20, no.5.
3. Aithal VK, Jenkins DH. Stabilization of a dislocating spastic hip with a carbon fiber ligament. Acta Orthop Scand, 1992, 63(6): 679.
4. Albinana J, Dolan L.A, Spratt K.f. Acetabular dysplasia after treatment for developmental dysplasia of the hip. J Bone Joint Surg. 2004, 86-B: 876-886.
5. Ponseti IV. Growth and development of the acetabulum in the normal child. J Bone Joint Surg[Am].1978, 60: 57.
6. Duff SR. Hip instability in young adult, broiler fowls. J Comp Pathol, 1985, 95(3): 373-382.
7. Ccnek R. Interposition of the ligamentum capitis femoris as a cause of impossible reduction of fracture-dislocation of the acetabulum. Lek List, 1953, 8(3-4): 56-58.
8. Singh S, Hee HT, Low VP. Singifiance of the lateral epiphsis of the acetabulum to hip joint stabity. J Pediatr Orthop, 2000, 20: 344-349.
9. Dunaj W. Microscopic structure of joint capsule, ligamentum teres and joint cartilage of femoral head in congenital dislocation of the hip. Chir Narzadow Ruchu Orthop, 1970, 35: 459.
10. 阮默, 徐达传. 股骨头韧带的研究进展. 中国临床解剖杂志, 2003, 21(1): 92-93.
11. Wren TA, Beaupre GS, Carter DR. Tendon and ligament adaptation to exercise, immobilization and remobilization. J Rehabil Res Dev, 2000, 37(2): 217-224.
12. Calandriello B, Mignani G. The Role of the Ligamentum Teres in Congenital Dislocation of the Hip. Clin Orthop, 1962, 22: 60.
13. Kamegaya M, Morya H, Tsuchiya K, et al. Arthrography of early Perthes’disease of the ligamentum teres as a cause of subluxation. J Bone Joint Surg [Br], 1989, 71(3):413-417.
14. Tan CK, Wong WC. Absence of the ligament of head of femur in the human hip joint. Singapore Med J, 1990, 31(4): 360-363.
15. Schneider PG, Thull-Emden J. Ligamentum capitis femoris and surgical reposition of hip dislocation in children. Histological and roentgenological studies. Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete, 1971, 109(3): 365-379.
16. Fritsch H, Hegemann L. Development of the ligamentum capitis femoris and the artery with the same name. Z Orthop Ihre Grenzgeb, 1991, 129(5): 447-452.
17. Gray AJ, Villar RN. The ligamentum teres of the hip: An arthroscopic classification of its pathology. Arthroscopy, 1997, 13(5): 575-578.
18. Thornton GM, Sh rive NG, Frank CB. Healing ligaments have decreased cyclic modulus compared to no rmal ligaments and immobilization further comp rom ises healing ligament response to cyclic loading. J Orthop Res, 2003, 21(4): 716-722.
19. 吉士俊, 刘卫东, 马瑞雪, 等. 胎儿髋关节形态发育变化的观察. 中华骨科杂志, 1988, 8(5): 264-266.
20. 马瑞雪, 吉士俊, 刘卫东, 等. 粗大圆韧带所致发育性髋脱位复位后股骨头坏死的临床特点. 中华小儿外科杂志, 1998, 4-19: 83-85.
21. Chen HH, Fen-Yau A. Adaptations of Ligamentum Teres in Ischemic Necrosis of Human Femoral Head. Clin Orthop, 1996, 328: 268-275.
22. Li AF, Li KC, Chen HH, et al. Biomechanical functions of ligamentum teres. Proceedings 1993 International Society of Biomechanics 14th Congress. Paris, 1993: 794-795.
23. Montes G. Structural biology of the fibres of the collagenous and elastic systems. Cell Biol Int, 1996, 20(1): 15.
24. vander Rest M, Garrone R. Collagen family of protein. FASEB J, 1991, 5(13): 2813-2815.
25. 张长杰. 膝关节制动对外侧副韧带胶原转化影响的观察. 中华理疗杂志, 2001, 24(4): 215-217.
26. Parry D-AD, Craig AS. Collagen Fibrils During Development and Maturation andTheir Contribution tothe Mechanical Attributes of Connective Tissue. In Nimni ME(ed). Collagen: Biochemistry and Biomechanics, 1988, 2: 1-22.
27. Sakai H, Koibuchi N, Ohtake H, et al. Type Ⅰ and type Ⅲ procollagen gene expressions in the early phase of ligament healing in rabbits: an in situhybridization study. J Orthop Res, 2001, 19(1): 132-135.
28. Mari MH, Teeling P, Mann J, et al. Dialated cardiomyopathy is associated with an increase in the typeⅠ, Ⅲ collagen ratio: a quantitative assessment. J Am Cell Cardiol, 1995, 25(6): 1263-1265.
29. Ippolito Er, Ishii Yo, Ignacio V, et al. Histologic, Histochemical, and Uitrastructural Studies of the Hip Jiont Capsule and Ligementum Teres in Congenital Dislocation of the Hip. Clin Orthop Rela Research, 1980, 146: 246-258.
30. Tipton CM, Vailas AC, Matthes RD. Experimental studies on the influences of phyisical activity on ligaments, tendons and joints: a brief review. Acta Med Scand, 1986, Suppl 711: 157.
31. Dudko, GE. The formation of the ligamentum capitis femoris in endoprosthesis. Orthop Travmatologiia Protezirovanie, 1989, 12: 57-58.
32. Stuecker RD, Brinker MR, Bennett JT, et al. Blood flow to the immature hip. Acta Crthop Scand, 1997, 68: 25.
33. Robben SG, Lequin MH, Diepstraten AF, et al. Doppler sonography of the anterior ascending cervical arteries of the hip: evaluation of healthy and painful hips in children. AJR, 2000, 174: 1629.
34. Trueta J, Harrison MHM. The normal vascular anatomy of the femoral head in adult man. J Bone Joint Surg, 1953, 35B: 442-461.
35. Gautier E, Ganz K, Krügel N. Anatomy of the medial femoral circumflex artery and its surgical implications. J Bone Joint Surg [Br], 2000, 82-B: 679-683.
36. Sevitt S, Thompson RG. The distribution and anastomoses of arteries supplying the head and neck of the femur. J Bone Joint Surg [Br], 1965, 47-B: 560-573.
37. 吉士俊, 马瑞雪, 周永德. 小儿髋关节外科, 第一版. 北京: 人民卫生出版社, 2005, 1(1): 23-24, 48-57.
38. Lee MC, Eberson CP. Growth and Development of the Child's Hip. Orthop Clin Nort Am, 2006, 37( 2): 119-132.
39. Shatsillo, Ariel BM. The anatomicofunctional characteristics of the hip joint. Morfologiia, 1996, 110(6): 112-115.
40. Fuss FK, Bacher A. New aspects of the morphology and function of the human hip joint ligaments. Am J Anatomy, 1991, 192(1): 1-13.
41. 马梦然, 王建设, 刘振东. 人工股圆韧带用于发育性髋关节脱位术后再脱位的治疗. 沈阳部队医药, 2005, 9: 327-328.
42. 姚海峰, 董悦农, 齐长明. 犬髋关节人造圆韧带手术初探. 中国兽医杂志, 2005, 11-7: 39-41.
43. Grosso FM, Grasso S. The ligamentum capitis femoris. Comparative anatomical study. Orizzonti Della Ortopedia Odierna e Della Riabilitazione, 1967, 12(1-4): 43-56.
44. Tanaka T, Yoshihashi Y, Miura T. Changes in soft tissue interposition after reduction of developmental dislocation of the hip. J Pediatr Orthop, 1994, 14(1): 16-23.
45. Dunaj W. Microscopic structure of joint capsule, ligamentum teres and joint cartilage of femoral head in congenital dislocation of the hip. Chir Narzadow Ruchu Orthop, 1970, 35: 459.
46. Ponseti IV. Morphology of the acetabulum in congenital dislocation of the hip. Gross, histological and roentgenographic studies. J Bone Joint Surg [Am], 1978, 60: 586-599.
47. Neverrov VA, Shilnikov VA. A method for forming an artificial ligament for the femur head in endoprosthesis. Vestn Khir Im Grek, 1993, 151(7-12): 81-83.
48. Zionts LE, MacEwen GD. Treatment of congenital dislocation of thehip in children between the ages of one and three years. J BoneJoint Surg [Am], 1986, 68-A: 829-46.
49. Tange Y, Eida T, Kojo Y. Contribution to the history of development of the ligamentum capitis femoris: including comments on its importance. Yokohama Medical, 1952, 3(3): 151-159.
50. Renshaw TS. Inadequate reduction of congenital dislocation of the hip. J Bone Joint Surg [Am], 1981, 63: 1114-1121.
51. Hama H, Yamamuro T, Takedo T. Experimental studies on connective tissue of thecapsular ligament. Influences of aging and sex hormones. Acta Orthop Scand, 1976, 47: 473.
52. Zadeh HG, Catterall A, Hashemi-Nejad A, et al. Test of stability as an aid to decide the need for osteotomy in association with open reduction in developmental dysplasia of the hip. From the Royal National Orthopaedic Hospital Trust, Stanmore, England: 2000, 1: 82-B.
53. James J, McCarthy, Peter V, et al. Developmental dysplasia of the hip(DDH). Current Orthopaedics, 2005, 19(3): 223-230.
2. Neverrov VA, Shilnikov VA. A method for forming an artificial ligament for the femur head in endoprosthesis.Vestn Khir Im Grek, 1993, 151(7-12): 81-83.
3. Ponseti IV. Growth and development of the acetabulum in the normal child. J Bone Joint Surg(Am), 1978, 60: 57F.
4. R Wynne-Davies. Familial joint laxity. Proc R Soc Med, Jun 1971, 64(6): 689-690.
5. Estrve, Rafael. Congenital Dislocation of the Hip. A Review and Assessment of Results of Treatment with Special Reference to Frame Reduction as Compared with Manipulative Reduction. J Bone and Joint Surg, 1960, 42-B: 253-263.
6. 吉士俊, 马瑞雪, 阿良, 等.髋臼发育不良的临床演变规律.中华骨科杂志, 2001, 10(21): 609-611.
7. Mari MH, Teeling P, Mann J, et al. Dialated cardiomyopathy is associated with an increase in the typeⅠ, Ⅲ collagen ratio: a quantitative assessment. J Am Cell Cardiol, 1995, 25(6): 1263-1265.
8. Vander Rest M, Garrone R. Collagen family of protein. Faseb J, 1991, 5(13): 2813-2815.
9. Tipton CM, Vailas AC, Matthes RD. Experimental studies on the influences of phyisical activity on ligaments、tendons and joints: a brief review. Acta Med Scand, 1986, Suppl 711: 157.
10. Montes G. Structural biology of the fibres of the collagenous and elastic systems. Cell Biol Int, 1996, 20(1): 15.
11. Chen HH, Li AF, Li KC, et al. Adaptations of ligamentum teres in ischemic necrosis of human femoral head. Clin Orthop, 1996, 328(6): 268-275.
12. Li AF, Li KC, Chen HH, et al. Biomechanical functions of ligatumentum teres. Proceedings 1993 International Society of Biomechanics 14th Congress. Paris, 1993:794-795.
13. Parry D-AD, Craig AS. Collagen Fibrils During Development and Maturation and Their Contribution tothe Mechanical Attributes of Connective Tissue. In Nimni ME(ed). Collagen: Biochemistry and Biomechanics, 1988, 2: 1-22.
14. Ippolito Er, Ishii Yo, Ignacio V. Histologic, Histochemical, and Uitrastructural Studies of the Hip Jiont Capsule and Ligementum Teres in Congenital Dislocation of the Hip. Clin Orthop, 1980, 146: 246-258.
15. 赵东风, 岳勇, 黄耀添, 等.先天性马蹄内翻足深筋膜胶原的免疫组化研究. 中华小儿外科杂志, 2004, 4(25): 182-184.
16. Sakai H, Ko ibuchi N, Ohtake H, et al. Type Ⅰ and type Ⅲprocollagen gene expressions in the early phase of ligament healing in rabbits: an in situhybridization study. J Orthop Res, 2001, 19(1): 132-135.
17. Fuss FK, Bacher A. New aspects of the morphology and function of the human hip joint ligaments. Am J Anatomy, 1991, 192(1): 1-13.
18. Staheli LT, Dion M, Tuell JI. The effect of the inverted limbus onclosed management of congenital hip dislocation. Clin Orthop, 1978, 137: 163-166.
19. Gage JR, Winter RB. Avascular Necrosis of the Capital Femoral Epiphysisas a Complication of Closed Reduction of Congenital Dislocation of the Hip. A Critical Review of Twenty Years’Experience at Gillette Children’s Hospital. J Bone and Joint Surg, 1972, 54-A: 373-388.
20. Walker JM. Growth characteristics of the fetal ligament of the head of femur:significance in congenital hip disease. Yale J Biol Med, 1980, 53(4): 307-316.
21. Lang A, Balint J. Anatomy of ligamentum teres femoris. Acta Morphologica Academiae Scientiarum Hungaricae, 1953, 3(3): 275-285.
22. Weinstein SL. Natural history and treatment outcomes of childhood hip disorders. Clin Orthop, 1997, 344: 227-242.
23. Chi-jeng L, Yung-tai L. Intraoperative Instablility for Developmental Dysplasia of the Hip in Children 12 to 18 Months of Age as a Guide to Salter Osteotomy. J Pediatr Orthop, 2000, 20: no.5.
24. Weathersby HT. The origin of the artery of the ligamentum teres femoris. J Bone Joint Surg[Am], 1959, 41-A, Issue 2: 261-263.
25. Jacques T. Superselective Angiography of the Hip. Radiology, 1977, 124: 648-650.
26. Gautier E, Ganz K, Krugel N, et a1. Anatomy of the medial femoral circum flex artery and its surgical implications. J Bone Joint Surg, 2001, 82(7): 679-683.
27. Fritsch H, Hegemann L.Development of the ligamentum capitis femoris and the artery with the same name. Z Orthop Ihre Grenzgeb, 1991, 129(5): 447-452.
28. Robben SG, Lequin MH, Diepstraten AF, et al. Doppler sonography of the anterior ascending cervical arteries of the hip: evaluation of healthy and painful hips in children. AJR, 2000, 174: 1629.
29. 吉士俊, 马瑞雪, 周永德. 小儿髋关节外科, 第一版. 北京: 人民卫生出版社, 2005, 1(1): 23-24, 48-57.
30. Stuecker RD, Brinker MR, bennett JT, et al. Blood flow to the immature hip. Acta Crthop Scand, 1997, 68: 25.
31. 王海洲, 周伟生. 股骨头血供的研究进展. 影像诊断与介入放射学, 2003, 12(4): 246-249.
32. 苗登顺, 吴永沐. 胎儿和婴儿股骨近端的血供及其临床意义. 中国临床解剖学杂志, 1988, 6(2): 68-71.
33. Lee MC, Eberson CP. Growth and Development of the Child's Hip. Orthop Clin Nort Am, 2006, 37(2): 119-132.
34. Kolodny A. The Architecture and the Blood Supply of the Head and Neck of the Femur and their Importance in the Pathology of Fractures of the Neck. J Bone Joint Surg, 1988, 7: 575.
35. Kalamchi A, MacEwen GD. Avascular necrosis following treatment of congenital dislocation ofthe hip. J Bone Joint Surg [Am], 1980, 62-A: 876-888.
36. Estrve, Rafael. Congenital Dislocation of the Hip. A Review and Assessment of Results of Treatment with Special Reference to Frame Reduction as Compared with Manipulative Reduction. J Bone Joint Surg, 1960, 42-B: 253-263.
37. 马瑞雪, 吉士俊, 刘卫东, 等.粗大圆韧带所致发育性髋脱位复位后股骨头坏死的临床特点.中华小儿外科杂志, 1998, 4-19: 83-85.
38. Salter RB, Kostuik J, Dallas S. Avascular Necrosis of the Femoral Head as a Complication of Treatment for Congenital Dislocation of the Hip in Young Children. A Clinical and Experimental Investigation. Canadian J Surg, 1969, 12: 44-61.
39. Marcin D, Marek S, et al. Avascular necrosis after surgical treatment for developmental dysplasia of the hip. Inter Orthop, 2004, 28: 65-68.
40. Coventry MB, Garcia AV, Mcdonald JR. Vascular changes of the ligamentum teres femoris in disease of the hip. Mayo Clinic Proceedings.1956, 31(22): 599-604.
41. Dunaj W. Microscopic structure of joint capsule, ligamentum teres and joint cartilage of femoral head in congenital dislocation of the hip. Chir Narzadow Ruchu Orthop, 1970, 35: 459.
42. Weiner DS, Hoyt WA, O'Dell HW. Congenital Dislocation of the Hip. The Relationship of Premanipulation Traction and Age to Avascular Necrosis of the Femoral Head. J Bone Joint Surg, 1977, 59-A: 306-311.
43. Howe WW, Lacey T, Schwartz RP. A study of the gross anatomy of the arteries supplying the proximal portion of the femur and acetabulum. J Bone Joint Surg, 1950, 32-A: 856-866.
44. Schink W, Parhofer R. Histological studies on the size of the arteries in the ligamentum capitis femoris. Langenbecks Arch Klin Chir Ver Dtsch Z Chir, 1962, 300: 306-313.
45. Grosso FM, Grasso S. The ligamentum capitis femoris. Comparative anatomical study. Orizzonti Della Ortopedia Odierna e Della Riabilitazione, 1967, 12(1-4): 43-56.
46. Chen HH, Fen-Yau A. Adaptations of Ligamentum Teres in Ischemic Necrosis of Human Femoral Head. Clin Orthop, 1996, 328: 268-275.
47. 赵群, 吉士俊, 周永德. 伸直外展位固定对幼猪股骨头发育的影响. 中华骨科杂志, 1992, 2-15: 101-104.
48. Tange Y, Eida T, Kojo Y. Contribution to the history of development of the ligamentum capitis femoris, including comments on its importance. Yokohama Medical, 1952, 3(3): 151-159.
49. Sanchis M, Zahir A, Freeman MA. The Experlnlental simulation of perthes disease by consecutive interruptions of the blood supply to the capital femoral epiphysls in the puppy. J Bone Joint Surg (Am), 1973, 55: 334-338.
50. Merkle U. On aging changes on the arteries of the ligamentum capitis femoris. Zeitschrift Fur Alternsforschung, 1965, 18(1): 10-12.
51. James J, McCarthy, Peter V, et al. Developmental dysplasia of the hip(DDH). Curr Orthop, 2005, 19(3): 223-230.
1. Harold P, Lehmann, Richard Hinton. Developmental Dysplasia of the Hip Practice Guideline. Pediatrics, 2000, Apr-105: e57.
2. Chii-jeng L, Yung-tai L. Intraoperative Instablility for Developmental Dysplasia of the Hip in Children 12 to 18 Months of Age as a Guide to Salter Osteotomy. J Pediatr Orthop, 2000, vol.20, no.5.
3. Aithal VK, Jenkins DH. Stabilization of a dislocating spastic hip with a carbon fiber ligament. Acta Orthop Scand, 1992, 63(6): 679.
4. Albinana J, Dolan L.A, Spratt K.f. Acetabular dysplasia after treatment for developmental dysplasia of the hip. J Bone Joint Surg. 2004, 86-B: 876-886.
5. Ponseti IV. Growth and development of the acetabulum in the normal child. J Bone Joint Surg[Am].1978, 60: 57.
6. Duff SR. Hip instability in young adult, broiler fowls. J Comp Pathol, 1985, 95(3): 373-382.
7. Ccnek R. Interposition of the ligamentum capitis femoris as a cause of impossible reduction of fracture-dislocation of the acetabulum. Lek List, 1953, 8(3-4): 56-58.
8. Singh S, Hee HT, Low VP. Singifiance of the lateral epiphsis of the acetabulum to hip joint stabity. J Pediatr Orthop, 2000, 20: 344-349.
9. Dunaj W. Microscopic structure of joint capsule, ligamentum teres and joint cartilage of femoral head in congenital dislocation of the hip. Chir Narzadow Ruchu Orthop, 1970, 35: 459.
10. 阮默, 徐达传. 股骨头韧带的研究进展. 中国临床解剖杂志, 2003, 21(1): 92-93.
11. Wren TA, Beaupre GS, Carter DR. Tendon and ligament adaptation to exercise, immobilization and remobilization. J Rehabil Res Dev, 2000, 37(2): 217-224.
12. Calandriello B, Mignani G. The Role of the Ligamentum Teres in Congenital Dislocation of the Hip. Clin Orthop, 1962, 22: 60.
13. Kamegaya M, Morya H, Tsuchiya K, et al. Arthrography of early Perthes’disease of the ligamentum teres as a cause of subluxation. J Bone Joint Surg [Br], 1989, 71(3):413-417.
14. Tan CK, Wong WC. Absence of the ligament of head of femur in the human hip joint. Singapore Med J, 1990, 31(4): 360-363.
15. Schneider PG, Thull-Emden J. Ligamentum capitis femoris and surgical reposition of hip dislocation in children. Histological and roentgenological studies. Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete, 1971, 109(3): 365-379.
16. Fritsch H, Hegemann L. Development of the ligamentum capitis femoris and the artery with the same name. Z Orthop Ihre Grenzgeb, 1991, 129(5): 447-452.
17. Gray AJ, Villar RN. The ligamentum teres of the hip: An arthroscopic classification of its pathology. Arthroscopy, 1997, 13(5): 575-578.
18. Thornton GM, Sh rive NG, Frank CB. Healing ligaments have decreased cyclic modulus compared to no rmal ligaments and immobilization further comp rom ises healing ligament response to cyclic loading. J Orthop Res, 2003, 21(4): 716-722.
19. 吉士俊, 刘卫东, 马瑞雪, 等. 胎儿髋关节形态发育变化的观察. 中华骨科杂志, 1988, 8(5): 264-266.
20. 马瑞雪, 吉士俊, 刘卫东, 等. 粗大圆韧带所致发育性髋脱位复位后股骨头坏死的临床特点. 中华小儿外科杂志, 1998, 4-19: 83-85.
21. Chen HH, Fen-Yau A. Adaptations of Ligamentum Teres in Ischemic Necrosis of Human Femoral Head. Clin Orthop, 1996, 328: 268-275.
22. Li AF, Li KC, Chen HH, et al. Biomechanical functions of ligamentum teres. Proceedings 1993 International Society of Biomechanics 14th Congress. Paris, 1993: 794-795.
23. Montes G. Structural biology of the fibres of the collagenous and elastic systems. Cell Biol Int, 1996, 20(1): 15.
24. vander Rest M, Garrone R. Collagen family of protein. FASEB J, 1991, 5(13): 2813-2815.
25. 张长杰. 膝关节制动对外侧副韧带胶原转化影响的观察. 中华理疗杂志, 2001, 24(4): 215-217.
26. Parry D-AD, Craig AS. Collagen Fibrils During Development and Maturation andTheir Contribution tothe Mechanical Attributes of Connective Tissue. In Nimni ME(ed). Collagen: Biochemistry and Biomechanics, 1988, 2: 1-22.
27. Sakai H, Koibuchi N, Ohtake H, et al. Type Ⅰ and type Ⅲ procollagen gene expressions in the early phase of ligament healing in rabbits: an in situhybridization study. J Orthop Res, 2001, 19(1): 132-135.
28. Mari MH, Teeling P, Mann J, et al. Dialated cardiomyopathy is associated with an increase in the typeⅠ, Ⅲ collagen ratio: a quantitative assessment. J Am Cell Cardiol, 1995, 25(6): 1263-1265.
29. Ippolito Er, Ishii Yo, Ignacio V, et al. Histologic, Histochemical, and Uitrastructural Studies of the Hip Jiont Capsule and Ligementum Teres in Congenital Dislocation of the Hip. Clin Orthop Rela Research, 1980, 146: 246-258.
30. Tipton CM, Vailas AC, Matthes RD. Experimental studies on the influences of phyisical activity on ligaments, tendons and joints: a brief review. Acta Med Scand, 1986, Suppl 711: 157.
31. Dudko, GE. The formation of the ligamentum capitis femoris in endoprosthesis. Orthop Travmatologiia Protezirovanie, 1989, 12: 57-58.
32. Stuecker RD, Brinker MR, Bennett JT, et al. Blood flow to the immature hip. Acta Crthop Scand, 1997, 68: 25.
33. Robben SG, Lequin MH, Diepstraten AF, et al. Doppler sonography of the anterior ascending cervical arteries of the hip: evaluation of healthy and painful hips in children. AJR, 2000, 174: 1629.
34. Trueta J, Harrison MHM. The normal vascular anatomy of the femoral head in adult man. J Bone Joint Surg, 1953, 35B: 442-461.
35. Gautier E, Ganz K, Krügel N. Anatomy of the medial femoral circumflex artery and its surgical implications. J Bone Joint Surg [Br], 2000, 82-B: 679-683.
36. Sevitt S, Thompson RG. The distribution and anastomoses of arteries supplying the head and neck of the femur. J Bone Joint Surg [Br], 1965, 47-B: 560-573.
37. 吉士俊, 马瑞雪, 周永德. 小儿髋关节外科, 第一版. 北京: 人民卫生出版社, 2005, 1(1): 23-24, 48-57.
38. Lee MC, Eberson CP. Growth and Development of the Child's Hip. Orthop Clin Nort Am, 2006, 37( 2): 119-132.
39. Shatsillo, Ariel BM. The anatomicofunctional characteristics of the hip joint. Morfologiia, 1996, 110(6): 112-115.
40. Fuss FK, Bacher A. New aspects of the morphology and function of the human hip joint ligaments. Am J Anatomy, 1991, 192(1): 1-13.
41. 马梦然, 王建设, 刘振东. 人工股圆韧带用于发育性髋关节脱位术后再脱位的治疗. 沈阳部队医药, 2005, 9: 327-328.
42. 姚海峰, 董悦农, 齐长明. 犬髋关节人造圆韧带手术初探. 中国兽医杂志, 2005, 11-7: 39-41.
43. Grosso FM, Grasso S. The ligamentum capitis femoris. Comparative anatomical study. Orizzonti Della Ortopedia Odierna e Della Riabilitazione, 1967, 12(1-4): 43-56.
44. Tanaka T, Yoshihashi Y, Miura T. Changes in soft tissue interposition after reduction of developmental dislocation of the hip. J Pediatr Orthop, 1994, 14(1): 16-23.
45. Dunaj W. Microscopic structure of joint capsule, ligamentum teres and joint cartilage of femoral head in congenital dislocation of the hip. Chir Narzadow Ruchu Orthop, 1970, 35: 459.
46. Ponseti IV. Morphology of the acetabulum in congenital dislocation of the hip. Gross, histological and roentgenographic studies. J Bone Joint Surg [Am], 1978, 60: 586-599.
47. Neverrov VA, Shilnikov VA. A method for forming an artificial ligament for the femur head in endoprosthesis. Vestn Khir Im Grek, 1993, 151(7-12): 81-83.
48. Zionts LE, MacEwen GD. Treatment of congenital dislocation of thehip in children between the ages of one and three years. J BoneJoint Surg [Am], 1986, 68-A: 829-46.
49. Tange Y, Eida T, Kojo Y. Contribution to the history of development of the ligamentum capitis femoris: including comments on its importance. Yokohama Medical, 1952, 3(3): 151-159.
50. Renshaw TS. Inadequate reduction of congenital dislocation of the hip. J Bone Joint Surg [Am], 1981, 63: 1114-1121.
51. Hama H, Yamamuro T, Takedo T. Experimental studies on connective tissue of thecapsular ligament. Influences of aging and sex hormones. Acta Orthop Scand, 1976, 47: 473.
52. Zadeh HG, Catterall A, Hashemi-Nejad A, et al. Test of stability as an aid to decide the need for osteotomy in association with open reduction in developmental dysplasia of the hip. From the Royal National Orthopaedic Hospital Trust, Stanmore, England: 2000, 1: 82-B.
53. James J, McCarthy, Peter V, et al. Developmental dysplasia of the hip(DDH). Current Orthopaedics, 2005, 19(3): 223-230.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |