同侧股骨近端截骨段的解剖学测量  

The anatomic measurement of ispilatera]proximal femoral autograft

作　　者：王守丰[1] 熊进[1] 詹朝双[2] 王爱国[1] 陈一心[1] 蒋青[1] 邱勇[1] 

机构地区：[1]南京大学医学院附属鼓楼医院骨科,210008 [2]南京大学医学院解剖学教研室,210093

出　　处：《中国骨肿瘤骨病》2011年第5期494-499,共6页Chinse Journal Of Bone Tumor And Bone Disease

基　　金：江苏省科技发展计划项目(BK2010109)

摘　　要：目的探讨同侧股骨近端截骨段生物学重建髋臼周围肿瘤切除术后缺损的适用范围。方法对13例男性新鲜冷冻尸体进行股骨近端解剖学测量。包括股骨头直径、股骨头顶点至股骨颈基底部的距离,股骨粗隆顶点至截骨处的距离,股骨粗隆顶点与股骨颈内侧缘的垂直距离,股骨头顶点至小粗隆下截骨线中点的长度,粗隆部的前后宽度共6个指标。5对股骨近端截骨段截取后测量。另外8对在解剖暴露完全后原位测量。13例股骨近端截骨段测量后数据汇总,进行统一分析。Mann-Whitney U检验对每个参数进行左右侧对比分析。应用Spearmen's相关分析各参数与体长相关程度。结果各测量参数左右侧对比无统计学差异(P>0.05)。各测量参数中位数(四分位间距)分别为49mm(48～52.7mm)、62.4mm(60～27.2mm)、83.5mm(75～87mm)、58.5mm(54.5～60.9mm)、102mm(96～105.2mm)和48mm(46.5～51mm)。各参数均与体长正相关(P<0.05)。结论同侧股骨近端截骨段在一定范围内可以生物学重建骨盆肿瘤切除后缺损。但必须评估肿瘤切除术后缺损大小、股骨近端截骨段粗隆部的宽度和高度。Objective To investigate the indication of biological reconstruction of defect after resection of malignant pelvic tumor with proximal femoral autograft. Methods The anatomic study of proximal femoral autografts was performed in 13 fresh-frozen male cadavers. The parameters of anatomic measurement included diameter of femoral head, distance between apex of femoral head and bottom line of femoral neck, distance between apex of greater trochanter and osteotomy line under lesser trochanter, distance of apex of greater trochanter perpendicular to medial cortex edge of femoral neck, length between apex of greater trochanter and midpoint of osteotomy line under lesser trochanter and width of greater trochanter anterior to posterior. 5 pairs of autografts were measured after they were osteotomized from. the left and right side proximal femurs of cadavers. The other 8 pairs of autografts were measured in situ after the proximal femurs were exposed, All the results were collected together. The comparison of all parameters between left and right side autograft was made by Mann-Whitney U test, The correlation of height with all parameters was analyzed by Spearmen＇s correlation. Results The significance was not found statistically in the comparison of all parameters between left and right proximal femoral autograft （P〉0.05）. The median （interquartile range） of the above mentioned parameters in the method were 49ram （range; 48-52.7mm）, 62.4mm （range; 60-27.2mm）, 83.5mm （range; 75-87mm）, 58.5mm （range; 54.5-60.9mm）, 102mm （range; 96-105.2mm） and 48ram （range; 46.5-5 lmm） respectively. There was positive correlation of height with all six parameters （P〈0.05）. Conclusions The biologic reconstruction of pelvic defect after tumor resection with proximal femoral autograft may be a good option within an appropriate magnitude. However, an individual preoperative plan should be careful to evaluate the size of bone defect after tumor resection and height and width of the remaining greater troch

关 键 词：骨盆缺损 生物重建 股骨近端截骨 解剖学测量 

分 类 号：R681.8[医药卫生—骨科学]