安装假体时股骨旋转定位轴线及相关角度的解剖学特征  

Anatomical characteristics of axial lines and angles of rotational alignment of the femur during prosthetic installation

作　　者：赵志江[1] 许红生[1] 孟位明 张小伟[1] 张磊[1] 

机构地区：[1]涿州市医院骨二科,河北省涿州市072750

出　　处：《中国组织工程研究》2014年第17期2632-2636,共5页Chinese Journal of Tissue Engineering Research

基　　金：河北省卫生厅指导性课题资助项目(20130688)~~

摘　　要：背景:人工全膝关节置换过程中股骨假体旋转定位良好是置换成功的关键之一,与置换后关节功能密切相关。股骨髁各项解剖参数也非常重要,熟悉其各项数据能够合理截骨以及选择轴线,避免假体安装位置不佳导致全膝关节置换后关节功能障碍。目的:通过对股骨髁标本的解剖结构进行观察,测量股骨髁标本解剖参数及定位轴线之间的角度。方法:固定架固定共40例股骨骨性标本,观察内上髁及外上髁形态变化,测量股骨髁解剖参数,包括长度、宽度等;应用定位导向器于内外上髁之间穿克氏针固定,垂直股骨后髁轴截骨后以万能角度量角器测量股骨4条轴线——手术髁上轴、临床髁上轴、后髁轴、AP轴之间的相关角度关系。结果与结论:内上髁凹陷出现比例较低,约占所有标本比例总数的25%;股骨髁的高度与西方人相比差别不大,宽度与西方人相比差别较大。提示股骨髁宽度与西方人群差别较大,手术操作应充分注意;股骨髁内上髁凹陷出现比例不高,故参照髁上轴的后髁角定位只适用于部分人群;而AP轴较易定位,两条轴线与后髁轴线之间成角数值稳定,变异性较小,证实AP轴可做为股骨假体旋转定位的可靠标记。BACKGROUND：Good rotational location for femoral prosthesis is a key in total knee replacement, which is strongly associated with joint function after replacement. Each anatomical parameter of femoral condyle is also very important. To familiar with each data can do reasonably ostectomy and select axis, can avoid poor location of prosthesis-induced joint dysfunction after total knee replacement. OBJECTIVE：To observe the anatomical structure of femoral condyle specimens, and measure the angle between anatomical parameter and the axis. METHODS：A total of 40 femoral bone specimens were fixed on the frame. Morphological changes in the medial epicondyle and the lateral epicondyle were observed. Femoral condyle parameters, including length and width, were measured. Kirschner wire was used between the medial epicondyle and the lateral epicondyle using a targeting device. After ostectomy, four axial lines were measured with a conimeter, including surgical epicondylar axis, clinical epicondylar axis, posterior condylar line and anterior-posterior axis. RESULTS AND CONCLUSION：The depression of medial epicondyle appeared relatively low, accounting for 25%of the total number of al specimens;the height of the femoral condyle did not have significant difference compared with westerners, but width was smal er compared with westerners. Thus, the surgeons should be ful y aware of the width of femoral condyle in operative procedures. The appearance of depression of medial epicondyle was not frequent, so posterior condylar angle of epicondylar axis was only fit for some persons. However, anterior-posterior axis was easily to be located. The angle between two axes and posterior condylar line was stable, and variability was smal . Thus, the anterior-posterior axis can be used as a reliable label for rotational position of femoral prosthesis.

关 键 词：植入物 人工假体 全膝关节置换 股骨 后髁轴 髁上轴 前后轴(AP轴) 

分 类 号：R318[医药卫生—生物医学工程]