X线研究大转子顶点与股骨头中心的关系  

Radiological assessment on relationship between greater trochanter tip and femoral head center

作　　者：路玉峰[1] 郭万首[2] 孙伟[2] 张启栋[2] 刘林[1] 许鹏[1] 

机构地区：[1]西安交通大学医学部附属红会医院关节病医院骨坏死与关节重建病区,710054 [2]中日友好医院骨关节外科,北京100029

出　　处：《中华关节外科杂志（电子版）》2016年第6期21-24,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨大转子顶点与同侧股骨头旋转中心的垂直距离正常变异范围,以及该距离分别与颈干角、偏心距的关系,推测其在髋关节置换时应用的可靠性。方法选择中日友好医院骨科门诊2013年6月至12月,符合标准的双侧髋关节正位X线450例,男性210例,女性240例;使用影像归档和通信系统(PACS)系统测量股骨头中心和同侧大转子顶点之间的垂直距离(大转子高度)。对比左右两侧大转子高度之间的差异。使用散点图和Pearson相关系数说明该距离与颈干角和偏心距的关系强度。结果所测股骨头中心与同侧大转子顶点的垂直距离平均值为(7.36±3.81)mm。右侧大转子高度值与左侧比较有统计学意义(t=8.637,P<0.001)。该距离与同侧颈干角相关性良(r=-0.685,P<0.01),与同侧偏心距相关性差(r=0.285,P<0.01)。结论全髋关节置换时,当股骨颈干角大于126°时,参照该关系来调整双下肢长度具有较大的可靠性。Objective To investigate vertical distance between the tip of the greater trochanter and center of the femoral head and its correlation with femoral offset and neck shaft angle, and to define normal variation in the vertical distance. Methods The vertical distance between the tip of the greater trochanter and center of the femoral head （greater trochanter height, GTH） , femoral offset and neck-shaft angles were measured on 450 standard anteroposterior radiographs of hip （210 males and 240 females） without obvious hip joint pathology. The fight and left greater trochanter heights were compared by paired samples t-test. The scatterplot and Pearson correlation coefficient was used to assess the correlation between the bilateral greater trochanter heights, as well as the correlation between neck-shaft angle, femoral offset and GTH. Results The mean GTH was （7. 36 ± 3.81 ） ram. Significant difference was found between the fight and left GTHs （ t = 8. 637, P 〈 0. 001 ）. The neck-shaft angle showed a good correlation with GTH （ r = -0. 685, P 〈 0. 01 ）, and the femoral offset showed a weak correlation with it （r = 0. 285, P 〈 0.01 ）. Conclusion When neck-shaft angle is greater than 126°, the greater reliability can be obtained by using the relationship between the tip of the greater trochanter and center of the femoral head to adjust leg length discrepancy in total hip arthroplasty.

关 键 词：关节成形术 置换 髋 股骨头 X线 解剖学 

分 类 号：R687.4[医药卫生—骨科学]