股骨上段髓腔径线研究及其临床意义  

Anatomical study of the medullary cavity of the proximal femoral bone and its clinical significance

作　　者：杜心如[1] 卢世璧[1] 

机构地区：[1]中国人民解放军总医院骨科,北京100853

出　　处：《中国临床解剖学杂志》2006年第4期359-363,共5页Chinese Journal of Clinical Anatomy

基　　金：北京市科委资助项目(H010410030112)

摘　　要：目的:为设计符合国人股骨髓腔形状的人工股骨柄提供股骨上段髓腔几何形态学基础。方法:成人股骨标本共160根,每根标本分别拍照正位、侧位、45°内斜位和45°外斜位的X线片。对小转子顶点上方20mm(D)、小转子顶点(E)、小转子顶点下方20mm(F)、峡部近端(L)、峡部(G)和峡部远端(M)处各平面髓腔各径线进行测量。结果:所测结果均符合或接近正态分布。股骨头位置在小转子顶点上方(47.3±5.9)mm;各处髓腔宽度:D(40.2±4.5)mm,E(23.4±3.6)mm,F(16.8±2.8)mm,G[内径(10.0±2.6)mm,外径(24.0±2.6)mm];L及M在小转子顶点下方(68.5±12.1)mm,(144.4±17.5)mm处;G在小转子顶点下(103.9±14.3)mm处;在相同平面,各径线的相关系数为0.239￣0.802。结论:西方人的髓腔较国人的大,进口假体与国人有时难以匹配,或术中需要将髓腔扩大,以适应假体大小。峡部只是在正位片上显现,其前后径及双斜径并无明显变窄。同一平面髓腔各方向径线呈高度正相关,选择及设计假体时应遵循此规律。Objective： To study the morphology of the medullary cavity of the proximal femur and provide data for designing the total hip component in China. Methods： 160 femoral bones were collected and taken the X-ray film at the anteroposterior, lateral, inner oblique at 45° and outer oblique at 45° positions. Standard periosteal （extra cortical） and endosteal （intra cortical） dimensions were determined by the direct measurement on each roentgenogram. Result： Most of these parameters approximated a Gaussian distribution （normal bell-shaped curve）. Scatter plots of the femoral data demonstrated that substantial variability was presented in every case. Pair wise correlation of the geometric parameters showed that all dimensions were significantly associated. The correlation coefficients varied from 0.239 to 0.802 in most instances, strong correlations were presented （r〉0.5） between the pairs of periosteal dimensions. Stronger correlations were noted between variables describing the width of the cavity in the vicinity of the lesser trochanter. The relationship was suggested between the internal and external profiles of the femoral cavity through the pairs of periosteal and endosteal dimensions. Based upon the measurement and the calculation, the width at the point 20mm above the lesser trochanter, at the center of the lesser trochanter, at the point 20mm below that was 40.2±4.5 mm, 23.4± 3.6 mm, 16.8±2.8 mm respectively. The width of mediolateral isthmus and the extra cortex at this level was 10.0±2.6mm, 24.0±2.6 mm respectively, the proximal and distal border of isthmus was 68.5±12.1 mm, 144.4±17.5 mm respectively. Conclusions： The availability of basic geometric data describing the proximal femur in the paper allows guidelines to be developed for the functional dimensions of femoral components, these anatomic data also are the assessment of the match between the shape of existing components and the proximal femur. It also gives the information that affect restoration of the prosthetic art

关 键 词：股骨 髓腔 解剖 人工髋关节 

分 类 号：R323.72[医药卫生—人体解剖和组织胚胎学] R687.42[医药卫生—基础医学]