腓骨小头上区域的影像学研究及其临床意义  

An imaging study of the superior region of capitulum fibulae

作　　者：储旭东[1] 谢友扬 骆宇春 施鑫[4] 蔡福金 朱建平 周敏 李宏 鞠刚 

机构地区：[1]南京大学医学院研究生院,210002 [2]无锡市惠山区人民医院放射科 [3]解放军第一O一医院骨科 [4]南京军区南京总医院骨科

出　　处：《中华创伤骨科杂志》2014年第1期47-51,共5页Chinese Journal of Orthopaedic Trauma

基　　金：江苏省自然科学基金（BK2010461）

摘　　要：目的通过影像学测量腓骨小头上区域的相关数据，以验证腓骨小头上入路方式的可行性并设计相应的解剖钢板。方法选择健康自愿者38名（共60膝），男22名（38膝），女16名（22膝）；年龄18～60岁，平均44．8岁。分别按性别和身高2种方式分组：按性别分为A1组（男，38膝）和A2组（女，22膝）；按身高分为B1组（156～170cm，23膝）和B2组（171～185cm，37膝）。将60膝进行CT扫描并三维重建，将外侧平台三维CT图像分为3区：I区为胫骨平台后外侧髁区域，Ⅱ区为腓骨小头上区域，Ⅲ区为胫骨前外侧区域，并测量腓骨小头关节面至胫骨外侧平台关节面的骨性区域数据。同时进行MRI扫描，测量胫骨外侧骨面与外侧副韧带之间的骨．韧带区域数据，将获取的数据进行相关分析。结果骨性区域最窄宽度平均为（11．13±1．43）mm，骨一韧带区域最窄宽度平均为（5．35S-O．78）mm。腓骨小头上区域测量结果显示：A1组骨性区域最窄宽度[（11．45±1．48）mm]较A2组[（10．58±1．34）mm]宽；B1组[（10．32±1．40）mm较B2组（11．63±1．45）mm]窄，差异均有统计学意义（P〈0．05）。而骨一韧带区域最窄宽度A1组[（5．45±0．82）mm]与A2组[（5．18±0．71）mm]、BI组[（5．11±0．74）mm]与B2组[（5．50±0．80）mm]比较差异均无统计学意义（P〉0．05）。结论腓骨小头上区域存在骨性空间及骨一韧带空间，可以设计腓骨小头上入路，胫骨外侧平台三维CT分区及各区数值对腓骨小头上入路解剖钢板的研制具有重要的指导意义。Objective To measure the radiological data of the fibular capitellum which can be used for design of a surgical approach and an anatomical plate for the fibular capitellum. Methods Enrolled in the present study were 38 healthy volunteers （60 normal knees）, including 22 males （38 knees） and 16 fe- males （22 knees） . They were aged from 18 to 60 years （average, 44.8 years） . They were divided into 2 groups twice according to gender and body height. Group A1 was males while group A2 females; group B1 included subjects of 156 to 170 em in height while B2 subjects of 171 to 185 em in height. The 60 knees were subjected to CT scan before three-dimensional （3-D） reconstruction for measurements of the bony region from the articular surface of the capitellum to the articular surface of the lateral tibial plateau. The 3-D CT images of the lateral tibial plateau were divided into 3 categories： division i covering the posterolateral condyle of the tibial plateau, division [[ covering the superior region of the capitellum and division ]]] covering the antero- lateral region of the tibia. At the same time, the 60 knees were examined by MRI scanning to measure the bone-ligament region from the lateral tibial plateau to the lateral collateral ligaments. All the data were ana- lyzed and compared. Results The narrowest width of the bony region was 11.13 ±1.43 ram; the nar- rowest width of the bone-ligament region was 5.35 ＋ 0. 78 mm. In division 11, the narrowest width of the bony region in group A1 （11.45 ~ 1.48 mm） was significantly longer than in group A2 （10.58 -＋ 1.34 ram）, but that in group B1 （10. 32 ~ 1.40 ram） was significantly shorter than in group B2 （11.63 ~ 1.45 mm） （ P 〈 0. 05）. The narrowest width of the bone-ligament region in division II was 5.45 ~ 0.82 mm in group A1, showing no significant difference from that in group A2 （5.18 ~0.71 mm）, B1 （5.11 -＋0. 74 ram） and B2 （5.50 ~0.80 mm） （ P 〉 0. 05）. Conclusions The bony space and bone-ligament spa

关 键 词：膝关节 骨板 成像 三维 磁共振成像 

分 类 号：R687.3[医药卫生—骨科学]