Zhendong Zhang, Haigang Jia, Ningtao Ren, Hui Cheng, Dianzhong Luo, Yong Li, Wei Sun, Jun Fu, Hong Zhang
{"title":"年轻股骨头软骨下应力性骨折患者交界性髋关节发育不良发生率高。","authors":"Zhendong Zhang, Haigang Jia, Ningtao Ren, Hui Cheng, Dianzhong Luo, Yong Li, Wei Sun, Jun Fu, Hong Zhang","doi":"10.1186/s10195-025-00870-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Limited research exists on young patients with femoral head subchondral stress fractures (SSF), especially regarding how hip anatomy may contribute to this condition. Few studies have explored the potential correlation between its pathogenesis and developmental dysplasia of the hip (DDH). We aimed to determine hip morphology in patients with femoral head SSF and analyze the distribution of various parameters reflecting hip coverage and stability.</p><p><strong>Materials and methods: </strong>Radiographic data of all patients with femoral head SSF who met the inclusion criteria between January 2019 and November 2023 were retrospectively reviewed. These data included the lateral center-edge angle (LCEA), Tönnis angle, anterior center-edge angle (ACEA), femoral head extrusion index, acetabular arc, femoral head lateralization, upsloping lateral sourcil, cliff sign, crossover sign, posterior wall sign, and ischial spine sign. We determined the proportion of borderline DDH (BDDH) and the distribution of each parameter on the affected side. Additionally, we compared differences between patients with LCEA < 25° and LCEA > 25°.</p><p><strong>Results: </strong>In affected hips, 15 cases (57.7%) had BDDH, 3 cases (11.5%) had DDH, and only 8 cases (30.8%) had a normal LCEA. On the contralateral side, 8 cases (30.8%) had BDDH, 4 cases (15.4%) had DDH, and 14 cases (53.8%) had normal LCEA. Abnormalities were prominent in the extrusion index (50.0%), acetabular arc (65.4%), femoral head lateralization (46.2%), cliff sign (42.3%), and posterior wall sign (65.4%). Among patients with affected-side LCEA < 25°, more than 50% exhibited abnormalities in ACEA, extrusion index, acetabular arc, cliff sign, or posterior wall sign. Among patients with normal LCEA on the affected side, most had acetabular retroversion, with 75.0% showing a positive crossover sign and 75.0% showing a positive ischial spine sign.</p><p><strong>Conclusions: </strong>This study revealed a notably high prevalence of BDDH in young patients with femoral head SSF. The various abnormalities observed in parameters reflecting coverage and stability in BDDH may explain the potential association between BDDH and femoral head SSF.</p><p><strong>Level of evidence iv: </strong>Retrospective case series.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"26 1","pages":"54"},"PeriodicalIF":3.7000,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354419/pdf/","citationCount":"0","resultStr":"{\"title\":\"High prevalence of borderline hip dysplasia in young patients with femoral head subchondral stress fractures.\",\"authors\":\"Zhendong Zhang, Haigang Jia, Ningtao Ren, Hui Cheng, Dianzhong Luo, Yong Li, Wei Sun, Jun Fu, Hong Zhang\",\"doi\":\"10.1186/s10195-025-00870-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Limited research exists on young patients with femoral head subchondral stress fractures (SSF), especially regarding how hip anatomy may contribute to this condition. Few studies have explored the potential correlation between its pathogenesis and developmental dysplasia of the hip (DDH). We aimed to determine hip morphology in patients with femoral head SSF and analyze the distribution of various parameters reflecting hip coverage and stability.</p><p><strong>Materials and methods: </strong>Radiographic data of all patients with femoral head SSF who met the inclusion criteria between January 2019 and November 2023 were retrospectively reviewed. These data included the lateral center-edge angle (LCEA), Tönnis angle, anterior center-edge angle (ACEA), femoral head extrusion index, acetabular arc, femoral head lateralization, upsloping lateral sourcil, cliff sign, crossover sign, posterior wall sign, and ischial spine sign. We determined the proportion of borderline DDH (BDDH) and the distribution of each parameter on the affected side. Additionally, we compared differences between patients with LCEA < 25° and LCEA > 25°.</p><p><strong>Results: </strong>In affected hips, 15 cases (57.7%) had BDDH, 3 cases (11.5%) had DDH, and only 8 cases (30.8%) had a normal LCEA. On the contralateral side, 8 cases (30.8%) had BDDH, 4 cases (15.4%) had DDH, and 14 cases (53.8%) had normal LCEA. Abnormalities were prominent in the extrusion index (50.0%), acetabular arc (65.4%), femoral head lateralization (46.2%), cliff sign (42.3%), and posterior wall sign (65.4%). Among patients with affected-side LCEA < 25°, more than 50% exhibited abnormalities in ACEA, extrusion index, acetabular arc, cliff sign, or posterior wall sign. Among patients with normal LCEA on the affected side, most had acetabular retroversion, with 75.0% showing a positive crossover sign and 75.0% showing a positive ischial spine sign.</p><p><strong>Conclusions: </strong>This study revealed a notably high prevalence of BDDH in young patients with femoral head SSF. The various abnormalities observed in parameters reflecting coverage and stability in BDDH may explain the potential association between BDDH and femoral head SSF.</p><p><strong>Level of evidence iv: </strong>Retrospective case series.</p>\",\"PeriodicalId\":48603,\"journal\":{\"name\":\"Journal of Orthopaedics and Traumatology\",\"volume\":\"26 1\",\"pages\":\"54\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-08-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354419/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthopaedics and Traumatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s10195-025-00870-x\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedics and Traumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s10195-025-00870-x","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
High prevalence of borderline hip dysplasia in young patients with femoral head subchondral stress fractures.
Background: Limited research exists on young patients with femoral head subchondral stress fractures (SSF), especially regarding how hip anatomy may contribute to this condition. Few studies have explored the potential correlation between its pathogenesis and developmental dysplasia of the hip (DDH). We aimed to determine hip morphology in patients with femoral head SSF and analyze the distribution of various parameters reflecting hip coverage and stability.
Materials and methods: Radiographic data of all patients with femoral head SSF who met the inclusion criteria between January 2019 and November 2023 were retrospectively reviewed. These data included the lateral center-edge angle (LCEA), Tönnis angle, anterior center-edge angle (ACEA), femoral head extrusion index, acetabular arc, femoral head lateralization, upsloping lateral sourcil, cliff sign, crossover sign, posterior wall sign, and ischial spine sign. We determined the proportion of borderline DDH (BDDH) and the distribution of each parameter on the affected side. Additionally, we compared differences between patients with LCEA < 25° and LCEA > 25°.
Results: In affected hips, 15 cases (57.7%) had BDDH, 3 cases (11.5%) had DDH, and only 8 cases (30.8%) had a normal LCEA. On the contralateral side, 8 cases (30.8%) had BDDH, 4 cases (15.4%) had DDH, and 14 cases (53.8%) had normal LCEA. Abnormalities were prominent in the extrusion index (50.0%), acetabular arc (65.4%), femoral head lateralization (46.2%), cliff sign (42.3%), and posterior wall sign (65.4%). Among patients with affected-side LCEA < 25°, more than 50% exhibited abnormalities in ACEA, extrusion index, acetabular arc, cliff sign, or posterior wall sign. Among patients with normal LCEA on the affected side, most had acetabular retroversion, with 75.0% showing a positive crossover sign and 75.0% showing a positive ischial spine sign.
Conclusions: This study revealed a notably high prevalence of BDDH in young patients with femoral head SSF. The various abnormalities observed in parameters reflecting coverage and stability in BDDH may explain the potential association between BDDH and femoral head SSF.
期刊介绍：
The Journal of Orthopaedics and Traumatology, the official open access peer-reviewed journal of the Italian Society of Orthopaedics and Traumatology, publishes original papers reporting basic or clinical research in the field of orthopaedic and traumatologic surgery, as well as systematic reviews, brief communications, case reports and letters to the Editor. Narrative instructional reviews and commentaries to original articles may be commissioned by Editors from eminent colleagues. The Journal of Orthopaedics and Traumatology aims to be an international forum for the communication and exchange of ideas concerning the various aspects of orthopaedics and musculoskeletal trauma.
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