X射线测量成人胫骨外侧平台与股骨外侧髁解剖关系在骨折复位中的意义  

Significance of X-ray measurement of the anatomical relationship between adult lateral tibial plateau and lateral femoral condyle in fracture reduction

作　　者：方闰 宁仁德 刘雨龙 毕程浩 周道斌 Fang Run;Ning Rende;Liu Yulong;Bi Chenghao;Zhou Daobin(Department of Orthopedics,Third Affiliated Hospital of Anhui Medical University,Hefei 230061,Anhui Province,China)

机构地区：[1]安徽医科大学第三附属医院骨科,安徽省合肥市230061

出　　处：《中国组织工程研究》2023年第13期2076-2080,共5页Chinese Journal of Tissue Engineering Research

基　　金：卫生健康应用医学研究项目(临床)资助项目(201917201),项目负责人:宁仁德。

摘　　要：背景:胫骨平台骨折术中平台宽度恢复与否,目前临床尚无统一参考标准,其对术后膝关节功能影响,国内外研究较少。目的:探究成人胫骨外侧平台与股骨外侧髁的解剖位置关系及其在SchatzkerⅡ型胫骨平台骨折宽度复位中的临床意义。方法:回顾性分析2019年12月至2021年6月安徽医科大学第三附属医院拍摄的标准中立位正常成人膝关节X射线片148例208膝(正常组),以及SchatzkerⅡ型胫骨平台骨折患者58例(58膝)术前及术后1年标准中立位膝关节X射线片(骨折组)。定义胫骨平台最外侧点为A点,股骨远端关节面最外侧点为B点,股骨外侧髁最外侧点为C点,分别测量A-B与A-C的水平距离,若B点在A点内侧记做(-),在A点外侧记做(+),同理记录A-C值。正常组按照男女及左右侧分组,进行组间对比,以发现成人胫骨外侧平台与股骨外侧髁的解剖位置关系。同时对SchatzkerⅡ型胫骨平台骨折患者进行术后1年膝关节美国特种外科医院评分,定义复位后A点在C点内侧为甲组,A点在C点外侧为乙组,比较甲、乙组的膝关节功能。结果与结论:①正常组男性、女性平均A-B值相比,差异无显著性意义(t=-1.86,P>0.05);正常组男性、女性平均A-C值相比,差异无显著性意义(t=0.70,P>0.05);正常组左侧、右侧平均A-B值相比,差异无显著性意义(t=-0.67,P>0.05);正常组左侧、右侧平均A-C值相比,差异无显著性意义(t=1.09,P>0.05);②正常组平均A-B值为(-3.60±0.84)mm,骨折组术前平均A-B值为(-5.28±1.16)mm,组间对比差异有显著性意义(t=10.28,P<0.05);正常组平均A-C值为(1.80±1.26)mm,骨折组术前平均A-C值为(1.09±2.18)mm,组间对比差异有显著性意义(t=2.37,P<0.05);③骨折组中甲组术后1年膝关节美国特种外科医院评分为(83.05±2.04)分,乙组为(75.97±1.91)分,组间对比差异有显著性意义(t=13.25,P<0.05);④提示成人胫骨外侧平台与股骨外侧髁的解剖学位置关系相对恒定,BACKGROUND:There is no unified clinical reference standard for the recovery of the plateau width during the operation of tibial plateau fracture,and there are few studies on its effect on the postoperative knee function at home and abroad.OBJECTIVE:To explore the anatomical relationship between adult lateral tibial plateau and lateral femoral condyle and its clinical significance about width reduction in SchatzkerⅡtibial plateau fractures.METHODS:The X-ray films of knee joint of 148 normal adults(208 knees)in normal neutral position(normal knee group)and X-ray films of SchatzkerⅡtibial plateau fractures of 58 cases(58 knees)(fracture group)from December 2019 to June 2021 in the Third Affiliated Hospital of Anhui Medical University were retrospectively analyzed.The lateral-most margins of the tibial plateau articular surface were defined as point A;the lateral femoral condyle articular surface was defined as point B;the lateral femoral epicondyle was defined as point C;the horizontal distances of A-B and A-C were measured separately;medial and lateral measurements to point A were recorded as(-)and(+).The A-C distance was recorded in the same way.They were grouped by sex and side factors,and the comparison between the groups was performed to find the anatomical relationship between the adult lateral tibial plateau and lateral femoral condyle.The Hospital for Special Surgery scale was performed for one year after surgery of SchatzkerⅡtibial plateau fractures.After reduction,point A on the inside of point C was defined as group A and point A on the outside of point C was defined as group B;the knee function of group A and group B was compared.RESULTS AND CONCLUSION:(1)There was no significant difference in the mean A-B distance of the normal knee group between males and females(t=-1.86,P>0.05).There was no significant difference in the mean A-C distance of the normal knee group between males and females(t=0.70,P>0.05).There was no significant difference in the mean A-B distance of the normal knee group between

关 键 词：胫骨平台 宽度 胫骨平台骨折 膝关节功能 骨折复位 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R683.4