国人胫骨平台内翻角的测量及其临床意义  

Measurement of verus inclination of the proximal tibia of Chinese and its relevance in TKA

作　　者：陶坤[1] 吴海山[1] 储小兵[1] 徐长明[1] 周晓波[1] 

机构地区：[1]第二军医大学长征医院骨科,上海市凤阳路415号200003

出　　处：《中国矫形外科杂志》2006年第6期434-436,442,共4页Orthopedic Journal of China

摘　　要：[目的]目前人工膝关节置换术(TotalKneeArthroplasty,TKA)中,冠状面上胫骨侧都采用垂直截骨,为了代偿由此所致的胫骨侧非对称截骨,需将股骨假体适度外旋位放置,以后髁轴为参照,其外旋角度等于胫骨平台内翻角。临床术中作者发现参照国外3.00°的标准进行手术时常常出现股骨假体外旋不足所致的一系列并发症,考虑到人种间的区别可能导致的细致解剖上的差异,因而设计了该课题,通过对正常国人X线片的测量,得出其胫骨平台内翻角的数值,为人工膝关节置换术时国人股骨假体的外旋放置角度提供参照。[方法]200例青年健康志愿者摄双侧小腿全长正位片,用AutoCAD软件分别测量小腿机械轴垂直线与胫骨平台面切线(PT角)及双侧股骨髁远端切线的夹角(FT角)。[结果]正常国人的平均PT角为4.06°,FT角为5.00°,均明显大于国外的的参考值。[结论]国人TKA手术以股骨后髁轴为参照时,后髁的外旋截骨角度应>3.00°放置,以5.00°为宜,以获得满意的股骨假体的外旋放置。[ Objective] To measure the verus inclination of the proximal tibial of young Chinese through radiographs and determine how many degrees should the femoral prothesis be externally rotationed during total knee arthroplasty（TKA）. [ Method ] Standardized anteroposterior radiographs of the entire lower legs of 200 volunteers＇were taken. Two angles were measured as followes：Angle PT： angle between tibial articular margins and a line perpendicular to the tibial mechanical axis;Angle UF-angle between the transcondylar tangent anda line perpendicular to the tibial mechanical axis. [ Result ] Angle PT has a mean value of 4. 06° and Angle UF is 5. 00°. [ Conclusion ] When the posterior condylar axis is used during TKA for Chinese, the femoral prothesis should be externally rotationed 5.00° to get the optimum rotational orientation.

关 键 词：全膝关节置换 胫骨平台 机械轴线 内翻角测毓 

分 类 号：R687.3[医药卫生—骨科学]