股骨近端解剖学标志评估股骨颈前倾角的数字化研究  

Digital research on anatomical marker of proximal femur in predicting femoralanteversion

作　　者：刘峰 杨永强 李阳杰 谢书康 LIU Feng;YANG Yong-qiang;LI Yang-jie;XIE Shu-kang(Department of Surgery,the Frist People Hospital of Qujing,Qujing,Yunnan 655000,China)

机构地区：[1]曲靖市第一人民医院手显微、足踝外科,云南655000

出　　处：《中国骨与关节损伤杂志》2023年第2期122-125,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的采用数字骨科技术对股骨近端解剖标志进行测量研究,分析股骨近端解剖标志评估股骨颈前倾角的可行性。方法纳入自2009-10—2020-12完成的77例双下肢全长CT扫描数据,在魔瞳骨科术前规划软件中对CT数据进行三维重建,模拟人工髋关节置换术截骨(股骨小粗隆上方5、10、15 mm处),测量股骨近端切面的后内侧皮质线(Posterior medial cortical line,PMC)、股骨近端切面的前侧皮质线(Anterior cortical line,AC)、股骨近端切面T线与股骨髁轴线夹角及股骨颈前倾角。采用Pearson相关性分析评估PMC线前倾角、AC线前倾角、T线前倾角与股骨颈前倾角的相关性。结果测量77例股骨颈前倾角为(17.4±8.8)°。股骨小粗隆上方5 mm截骨时,PMC线前倾角为(1.22±4.11)°,AC线前倾角为(-17.01±5.88)°,T线前倾角为(-2.33±5.91)°,PMC线前倾角、AC线前倾角、T线前倾角与股骨颈前倾角呈显著正相关性。股骨小粗隆上方10 mm截骨时,PMC线前倾角为(1.57±3.99)°,AC线前倾角为(-16.01±5.09)°,T线前倾角为(-1.99±4.43)°,PMC线前倾角、AC线前倾角、T线前倾角与股骨颈前倾角呈显著正相关性。股骨小粗隆上方15 mm截骨时,PMC线前倾角为(2.82±5.00)°,AC线前倾角为(-15.54±3.94)°,T线前倾角为(2.11±4.95)°,PMC线前倾角、AC线前倾角、T线前倾角与股骨颈前倾角呈显著正相关性。结论考虑到PMC线、AC线显露更为简单,解剖结构更清晰,不需要考虑截骨面角度的影响,人工髋关节置换术中可参考PMC线、AC线评估股骨颈前倾角。Objective To measure the proximal anatomical markers of femur with digital orthopedic technology,and explore the feasibility of proximal anatomical markers in evaluating the femoral neck anteversion.MethodsWith the accumulated data of 77 patients who underwent full-length CT scanning of both lower limbs in our hospital from October 2009 to December 2020,three-dimensional reconstruction of the CT data was performed in the preoperative planning software of mydriasis orthopedics,to simulate the hip arthroplasty osteotomy(5 mm,10 mm and 15 mm above the small trochanter),measure the anteversion of posterior medial cortical line(PMC line),anteversion of anterior cortical line(AC line),anteversion of T line,and neck anteversion(FNA).Using the Pearson correlation coefficient,the correlation between the anteversion angles of the PMC,AC,T lines,and femoral neck was analyzed.Results In 77 cases,the anteversion angle of the femoral neck was measured to be(17.4±8.8)°.When cuts were made at 5 mm above the femoral tuberosity,the anteversion angles of the PMC line,AC line,and T line were(1.22±4.11),(-17.01±5.88)°,and(-2.33±5.91)°,respectively.Also,all three of these anteversion angles were significantly and positively correlated with the anteversion angle of the femoral neck.When cuts were made at 10 mm above the femoral tuberosity,the anteversion angles of the PMC line,AC line,and T line were(1.57±3.99)°,(-16.01±5.09)°,and(-1.99±4.43)°,respectively.Moreover,all these three anteversion angles were significantly and positively correlated with the anteversion angle of the femoral neck.When cuts were made at 15 mm above the femoral tuberosity,the anteversion angles of the three lines were(2.82±5.00)°,(-15.54±3.94),and(2.11±4.95)°,respectively.Furthermore,all three of these anteversion angles were significantly and positively correlated with the anteversion angle of the femoral neck.Conclusion Given that the PMC line and AC line are easy to be anatomically exposed and the angle of the osteotomy plane is not our con

关 键 词：人工髋关节置换术 股骨颈前倾角 后内侧皮质线 前侧皮质线 数字骨科技术 

分 类 号：R683.42[医药卫生—骨科学]