汉族人群正常股骨远端旋转对线的研究及其临床意义  

The study of the distal femur rotational alignment in the Han nationality and its clinical significance

作　　者：潘江[1] 曲铁兵[1] 温亮[1] 马德思 刘百峰[1] 孟令鑫[1] 辛星[1] 赵潇雄 陈伟[2] 黄伟[3] 陈虹[3] 王敏 张强[5] 彭理斌[6] 

机构地区：[1]首都医科大学附属北京朝阳医院骨科,100020 [2]河北医科大学第三医院骨科,100020 [3]重庆医科大学附属第一医院骨科,100020 [4]重庆新桥医院骨科,100020 [5]中国人民解放军总医院骨科,100020 [6]新疆医科大学附属第一医院骨科,100020

出　　处：《中华骨科杂志》2014年第4期387-393,共7页Chinese Journal of Orthopaedics

摘　　要：目的探讨中国汉族人群正常股骨远端旋转对线的相互关系及其临床意义。方法2012年10月至2013年7月，对北京、河北、新疆及重庆的409名健康成年汉族志愿者行下肢全长CT扫描，获取746个正常膝关节图像数据。男214名，女195名；年龄17-65岁，平均37．7岁；左膝374个，右膝372个。通过垂直于股骨机械轴线的断层图像进行膝关节重建，对轴线参数进行平面测量，包括股骨后髁角、髁扭转角、临床上髁轴线与外科上髁轴线夹角。按性别和侧别进行分组，比较轴线参数的差异。结果股骨后髁角平均为3．29°±1．24。、男性3-31°±1．30°、女性3．26°±1．17°、左膝3．24°±1．26°、右膝3．33°±1．22°，髁扭转角平均为7．06°±1．63°、男性7．02°±1．63°、女性7．11°±1．63°、左膝7．06°±1．68°、右膝7．06°±1．58°，不同性别及侧别股骨后髁角及髁扭转角的差异无统计学意义；临床上髁轴线与外科上髁轴线夹角平均为3．81°±1．14°、男性3．72°±1．11°、女性3．91°±1．17°、左膝3．83°±1．20°、右膝3．80°±1．08°，不同侧别临床上髁轴线与外科上髁轴线夹角的差异无统计学意义，不同性别临床上髁轴线与外科上髁轴线夹角的差异有统计学意义，女性大于男性。结论通过较大样本的中国汉族人群正常膝关节的影像学观察和测量，得到相对准确的国人股骨远端旋转轴线数据，从而精确指导手术操作。股骨远端的旋转对线应联合多种方法确定。[Abstract]Han nationality and investi-gate its clinical application. Methods 409 volunteers （214 males and 195 females） from Beijing, Hebei, Xinjiang and Chongq-ing, aged from 17 to 65 （37.7 in average） had undergone CT scan of their lower limbs. The CT scan images of 746 normal knees （374 left and 372 right knees） were obtained. With computer-assisted image processing and reconstruction, the correlative parame- ters, including posterior condylar angle （PCA）, condylar twist angle （CTA）, and the angle between clinical transepicondylar axis and surgical transepicondylar axis （CSA） were measured. The parameters of two groups between males and females, as well as left and right sides were analyzed. Results PCA： 3.29°± 1.24° in average, 3.31°± 1.30° in males, 3.26°± 1.17° in females, 3.24°± 1.26° in left knees and 3.33°± 1.22° in right knees. CTA： 7.06°± 1.63° in average, 7.02°± 1.63° in males, 7.11°± 1.63° in females, 7.06°±1.68° in left knees and 7.06°±1.58° in right knees. CSA： 3.81°±1.14° in average, 3.72°±1.11° in males, 3.91°±1.17° in fe-males, 3.83°± 1.20° in left knees and 3.80°± 1.08° in right knees. There was no significant difference between males and females, as well as left and right side in terms of PCA and CTA. There was no significant difference between left and right side, while there was significant difference between males and females in terms of CSA. CSA was larger in females than in males. Conclusion The result of the distal femur rotational alignment in normal Han nationality obtained in this study is relatively accurate, which could make it more precise in total knee arthroplasty. Individual handling and different locating methods should be applied on the determination of distal femur rotational alignment in the surzerv.

关 键 词：关节成形术 置换 膝 股骨 体层摄影术 X线计算机 

分 类 号：R687.4[医药卫生—骨科学] R816.8[医药卫生—外科学]