手舟骨中轴与第二掌骨长轴夹角测量研究  

Measurement of the angle between the middle axis of the scaphoid bone and the long axis of the second metacarpal bone

作　　者：申运山 金德富 周立亚 蒋云峰 Shen Yunshan;Jin Defu;Zhou Liya;Jiang Yunfeng(Department of Microsurgery and Hand Surgery,Xiangyang Hospital of Traditional Chinese Medicine,Xiangyang Institute of Traditional Chinese Medicine,Xiangyang 441000,China)

机构地区：[1]襄阳市中医医院(襄阳市中医药研究所)显微手外科,襄阳441000

出　　处：《中华手外科杂志》2023年第4期305-308,共4页Chinese Journal of Hand Surgery

基　　金：襄阳市科学技术局2020年度医疗卫生领域科技计划项目(2020ZD20)。

摘　　要：目的通过模型研究手舟骨中轴与第二掌骨长轴冠状位、矢状位、自然夹角的变化规律,为手舟骨骨折行掌侧入路固定手术提供理论依据。方法随机选取我院腕关节三维CT检查患者共90例,分为3组:A组成年男性左侧腕(31例)、B组成年男性右侧腕(31例)、C组成年女性右侧腕(28例)。按照1∶1打印出腕关节模型。将克氏针分别沿舟骨中轴和第二掌骨长轴穿针。摄X线正侧位、自然夹角位片,测量各自的夹角。结果手舟骨中轴与第二掌骨长轴冠状位夹角为(61.1±12.2)°、矢状位夹角(77.2±10.8)°、自然夹角(77.6±8.8)°。三组间冠状位夹角差异有统计学意义(P<0.05)。A、B组间冠状位夹角差异有统计学意义(P<0.05),矢状位、自然夹角差异无统计学意义(P>0.05)。B、C组间三个角度差异无统计学意义(P>0.05)。结论通过对模型手舟骨中轴与第二掌骨长轴夹角的测量,明确了角度的变化规律,为舟骨骨折掌侧入路固定手术提供重要的指导价值。Objective To study the changes of the coronal,sagittal and natural angles between the central axis of the scaphoid bone and the long axis of the second metacarpal bone by models,so as to provide a theoretical basis for fixation of scaphoid bone fractures through the volar approach.Methods A total of 90 patients with wrist joint 3D CT examination in our hospital were randomly selected and divided into three groups:group A adult male left wrist(31 cases),group B adult male right wrist(31 cases),and group C adult female right wrist(28 cases).The wrist joint model was printed in 1∶1.The Kirschner wire was punctured along the central axis of the scaphoid bone and the long axis of the second metacarpal bone.The X-ray anterolateral position and natural included angle position films were conducted,and their included angles were measured.Results The angle between the central axis of the scaphoid and the long axis of the second metacarpal bone was(61.1±12.2)°in the coronal position,(77.2±10.8)°in the sagittal position,and(77.6±8.8)°in the natural position.There was significant difference in coronal included angle among the three groups(P<0.05).There was statistically significant difference in the included angle of coronal position between group A and group B(P<0.05),but there was no statistically significant difference in the included angle of sagittal position and natural position(P>0.05).There was no significant difference in three angles between group B and group C(P>0.05).Conclusion Through the measurement of the angle between the central axis of the scaphoid bone and the long axis of the second metacarpal bone of the model hand,the changing rule of the angle was clarified,which provided important guiding value for the fixation of scaphoid fractures through the volar approach.

关 键 词：舟骨 掌骨 3D打印 轴线 角度测量 

分 类 号：R687.3[医药卫生—骨科学]