CT测量高原藏族成人股骨后髁角的临床研究  

A Clinical Study on CT Measurement of the Posterior Condyle Angle of Femur in Tibetan Adults

作　　者：李嘉 冯品 邓立庆 田臻 欧阳翔宇 黄奇 高峰 Li Jia;Feng Pin;Deng Liqing(Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region Chengdu,Chengdu 610041,China)

机构地区：[1]西藏自治区人民政府驻成都办事处医院骨科,四川成都610041

出　　处：《实用骨科杂志》2021年第12期1091-1095,共5页Journal of Practical Orthopaedics

基　　金：院级科研项目(2019-YJ-6);西藏自治区自然科学基金项目(XZ 2019ZR G-131)。

摘　　要：目的CT测量中国高原地区藏族健康成年人股骨后髁角,比较藏族和汉族成年人股骨后髁角(posterior condylar angle,PCA)的差异并总结其临床意义。方法纳入2020年1月至2020年10月西藏自治区人民政府驻成都办事处医院体检健康的藏族成年志愿者55例110膝,男30例(60膝),女25例(50膝);年龄25~48岁;平均年龄(32.19±11.15)岁;应用64排螺旋CT进行0.75mm扫描及三维重建,将获得的影像资料导入Auto Cad 2012及Camera Measure 2.1.3.250软件进行测量,获得评估股骨髁旋转角度的数据,分组后与其他文献比较,分析藏汉民族包括股骨后髁角在内的股骨远端旋转角度的差异。结果藏族成人PCA平均(3.16±0.55)°;男性平均(3.32±0.54)°,女性平均(2.97±0.50)°;左膝平均(3.17±0.60)°,右膝平均(3.15±0.53)°。髁扭转角(condylar torsion angle,CTA)平均(6.26±0.77)°;男性平均(6.28±0.80)°,女性平均(6.25±0.75)°;左膝平均(6.28±0.78)°,右膝平均(6.25±0.78)°。PCA、CTA在性别和左右两侧的比较,差异无统计学意义。临床上髁轴线与外科上髁轴线夹角(condylar shaft angle,CSA)平均(3.10±0.41)°;男性平均(2.95±0.40)°,女性平均(3.27±0.37)°;左膝平均(3.27±0.37)°,右膝平均(3.10±0.44)°。CSA在性别上比较,女性大于男性,差异有统计学意义。结论高原地区藏族成人PCA与国内文献报道中汉族成人角度近似,符合汉藏同源的观点。藏族PCA有性别差异,高原藏族成年男性全膝关节置换中仍适用股骨远端截骨外旋3°的标准,女性是否适合这个标准有待验证。Objective To measure the posterior condylar angle(PCA)of the femur in healthy adults from Tibetan Plateau of China wihCTscans,compared the results with those of Chinese Han and explorethe clinical significance of the results.Methods From January 2020 to October 2020,55 healthy adult volunteers from Tibetan Plateau of China who had healthy physical examinations at the Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region were enrolled.There were 30 males(60 knees)and 25 females(50 knees)with an average age of(32.19±11.15)years old(range,25~48).All patients had 64-slice CT scans of the knees done with a slice thickness of 0.75 mm and three-dimensional reconstruction was conducted.The images were distinguished in Auto Cad 2012 and Camera Measure 2.1.3.250 software to measure the rotation angles of femoral condyle including PCA.The measurement results were compared with the data of Chinese Han in literature and subgroup analysis was performed.Results The average PCA of Tibetan adults was(3.16±0.55)°,mean of(3.32±0.54)°for males versus(2.97±0.50)°for females,and mean of(3.17±0.60)°for left knees versus(3.15±0.53)°for right knees.The average condylar torsion angle(CTA)of Tibetan adults was(6.26±0.77)°,mean of(6.28±0.80)°for males versus(6.25±0.75)°for females,and mean of(6.28±0.78)°for left knees versus(3.15±0.53)°for right knees.The difference of gender and sides on both PCA and TCA were not statistically significant.The condylar shaft angle(CSA)which was formed by the intersection of clinical epicondylar axis and the surgical epicondylar axis was(3.10±0.41)°in average,mean of(2.95±0.40)°in males versus(3.27±0.37)°for females and mean of(3.27±0.37)°for left knees versus(3.10±0.44)°for right knee.The average CSA in females was larger than that of the males and the difference was statistically significant.Conclusion The PCA of adults from Tibetan Plateau of China is similar to that of Chinese Han adults reported in domestic literature,which supports the view that C

关 键 词：高原地区 藏族 膝关节置换 股骨后髁角 

分 类 号：R687.4[医药卫生—骨科学]