股骨上段髓腔角度几何形态学研究  

Anatomical study of the angle of the proximal femoral canal

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5期506-509,共4页Chinese Journal of Clinical Anatomy

基　　金：北京市科委资助项目(H010410030112)

摘　　要：目的:为了设计符合大多数病人股骨髓腔形状的人工股骨柄,减少术后并发症,对股骨上段髓腔角度几何学形态进行了研究。方法: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。对髓腔角度、颈干角、前倾角进行测量。结果:髓腔角度侧位∠1、∠2、∠3分别为13.9°±10.5°(0°￣52.0°)、10.0°±4.2°(0°￣22.0°)、7.6°±2.2°(2.0°￣15.0°);内斜位分别为30.8°±9.7°(3.0°￣57°)、7.1°±3.8°(0°￣17.0°)、5.3°±2.5°(0°￣40.0°);外斜位分别为49.2°±8.6°(0°￣62.0°)、4.5°±3.5°(0°￣16.0°)、3.7°±2.3°(0°￣10.0°)。股骨颈干角128.4°±7.0°,前倾角为9.4°±6.6°。结论:(1)股骨前倾角、颈干角国人数据差值较大;(2)人工髋关节设计的型号需多样化,型号齐全及部件配组是解决假体匹配关键问题之一;(3)在侧位片及双斜位片上,股骨髓腔呈现2个弯曲,上部弯曲向后,下部弯曲向前,呈“S”形,而不是直的;(4)髓腔的形态在侧位及双斜位片与正位不同,并非直筒形,假体柄的设计应有一定的弯曲角度,目前通用的直柄假体难以匹配。Objective： To study the angle of the proximal femur canal for designing total hip components and avoiding postoperative complications. Methods： One hundred and sixty femora labeled for identification and record were taken X-ray film on the anteroposterior, lateral, inner oblique at 45° and outer oblique at 45° position. The angle of the proximal femoral canal,the neck-shaft angle and the anteversion angle were measured on the X-ray films. Resulta： Most of these angles approximated a Gaussian distribution （normal bell-shaped curve）. Scatter plots of the femoral data demonstrated that substantial variability presented in every instance. The neck-shaft angle and the anteversion angle was about 128.4°±7.0°and 9.4°±6.6°respectively. The angle of the proximal femoral canal for 〈1, 〈2,〈3 was 13.9°±10.5°（0°-52.0°）, 10.0°±4.2° （0°-22.0°） and 7.6°±2.2°（2.0°-15.0°） on the lateral films, 30.8°±9.7°（3.0°-57°）, 7.1°±3.8° （0°-17.0°） and 5.3°±2.5° （0°±40.0°） on the inner oblique films, and 49.2°±8.6° （0° - 62.0°）, 4.5°±3.5° （0°-16.0°） and 3.7°±2.3° （0°- 10.0°） on the outer oblique films respectively. Conclusions： The data of the anteversion angle, the neck-shaft angle and the angle of the upper femur can take the detailed reference information for designing the total hip components. In my opinion, the key to solve the problem of the match of component of the femur medullary canal was that the types of the total hip components should be much more enough and varied to meet the clinical needs because there is an obvious difference between the samples. In the lateral and the oblique view the femur presents an anterior bow in upper part and a compensating posterior bow in the lower part, thus the whole shape looks like a ＂s＂ shape, not straight. The stem should be designed to curve for a close match with different implants. The posterior curve of the proximal femur may be described by an arc that bisects the proximal femora

关 键 词：股骨 髓腔角度 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]