中国人股骨近端的测量参数在股骨颈骨折经皮空心拉力螺钉技术的临床意义  

The Clinical Significance of the Measurement Parameters of the Proximal Femur in the Femoral Neck Fracture Percutaneous Cannulated Screw Technique

作　　者：韦积华[1] 韦庆军[1] 肖仕辉[1] 李伟岸[1] 

机构地区：[1]广西医科大学第一附属医院,广西南宁530021

出　　处：《中国医学创新》2012年第23期1-3,共3页Medical Innovation of China

基　　金：广西卫生厅重点科研课题(编号:桂卫重200835)

摘　　要：目的:对股骨近端进行形态学观察和测量,掌握股骨近端的形态和几何参数特征,用于指导股骨颈骨折经皮空心钉技术中的定位判断。方法:(1)将90侧干性股骨骨骼标本,进行大体观察,并测量股骨颈后缘基底的倾斜角度Angleα。(2)选取30侧标本制作成股骨颈、股骨头系列断面,通过系列断面的投影图来确定股骨颈前后缘最窄处在股骨头的投影。并确定股骨头投影的圆心O和股骨头的顶点C,然后在确定通过股骨颈前后缘最窄处在此重叠图上的位置,标出前后缘端点的垂直线与该球形上半弧形的交点A、B,分别定AOC、BOC的角度为Angleβ、Angleθ,并测量出其大小,并通过这些角度来推算出A、B点在该钟面上所代表的时间点。结果:(1)正面观股骨颈前缘几乎与股骨近端骨皮质前缘相切,仅在股骨颈中下缘略斜向后;后面观股骨颈后缘自小转子中点斜向上前,止于粗隆的上、前缘;整体观股骨颈最窄处位于股骨颈中部,呈椭圆形,椭圆形的长轴方向为自后下斜向前上。(2)中国人股骨颈后缘的倾斜角度为Angleα(64.00°±2.31°),股骨颈最窄处前后缘在股骨头的投影参数为Angleβ(29.93°±2.87°)和Angleθ(50.62°±2.69°),相当于钟面上的时间点为11点到13点40之间。结论:了解股骨近端的大体形态特点、测定股骨颈后缘的倾斜角度和股骨颈最窄处前后缘在股骨头的投影参数,可用于指导股骨颈骨折经皮空心拉力螺钉技术的定位、定向操作。Objective：To observe and measure the parameter of proximal femur anatomy, for percutancous screw Fixation for the fractures of femoral neck.Method：90 dried femur specimens were included in this study.The angle of inclination of the posterior the femoral neck was measured and recorded as the posterior slant angle（Angle α）.30 femur specimens were made into section and the projection of these section was determined.By measuring the borders of the projection, the projective line of anterior and posterior borders of the femoral neck in the heacl of femur was determined. According to the results acquired from this study, the projective parameters（Angle [3, Angle 0） were acquired, the data were expressed as Mean＋Standard Deviation and analyzing the data by using the descriptive methods with SPSS13.0, explored the ＂safe area＂ infemoral neck fractures surgery.Result ：The proximal femoral femoral is irregular bone, and each part has some morphological character. Angle α （64.00°±2.31° ）, Angleβ （29.93°± 2.87° ）, Angle0（50.62°±2.69°）.Through analyzing the angle of inclination of the posterior the femoral neck and the projective line of the femoral neck anterior and posterior borders in the head of femur and using anatomical knowledge, ＂safe area＂ in femoral neck fractures surgery can he established.Conclusion：It＇ s useful for operation of percutaneous screw fixation for the fractures of femoral neck to observe and measure the proximal femur.

关 键 词：股骨近端 解剖 几何形态 测量 股骨颈骨折 空心拉力螺钉 

分 类 号：R687.3[医药卫生—骨科学]