CAJ | 학술논문

目的探讨中国汉族人群正常股骨远端旋转对线的相互关系及其临床意义.方法 2012年10月至2013年7月,对北京、河北、新疆及重庆的409名健康成年汉族志愿者行下肢全长CT扫描,获取746个正常膝关节图像数据.男214名,女195名;年龄17 ～ 65岁,平均37.7岁;左膝374个,右膝372个.通过垂直于股骨机械轴线的断层图像进行膝关节重建,对轴线参数进行平面测量,包括股骨后髁角、髁扭转角、临床上髁轴线与外科上髁轴线夹角.按性别和侧别进行分组,比较轴线参数的差异.结果股骨后髁角平均为3.29°±1.24°、男性3.31°±1.30°、女性3.26°±1.17°、左膝3.24°±1.26°、右膝3.33°±1.22°,髁扭转角平均为7.06°±1.63°、男性7.02°±1.63°、女性7.11°±1.63°、左膝7.06°±1.68°、右膝7.06°±1.58°,不同性别及侧别股骨后髁角及髁扭转角的差异无统计学意义;临床上髁轴线与外科上髁轴线夹角平均为3.81°±1.14°、男性3.72°±1.11°、女性3.91°±1.17°、左膝3.83°±1.20°、右膝3.80°±1.08°,不同侧别临床上髁轴线与外科上髁轴线夹角的差异无统计学意义,不同性别临床上髁轴线与外科上髁轴线夹角的差异有统计学意义,女性大于男性.结论通过较大样本的中国汉族人群正常膝关节的影像学观察和测量,得到相对准确的国人股骨远端旋转轴线数据,从而精确指导手术操作.股骨远端的旋转对线应联合多种方法确定.
목적 탐토중국한족인군정상고골원단선전대선적상호관계급기림상의의.방법 2012년10월지2013년7월,대북경、하북、신강급중경적409명건강성년한족지원자행하지전장CT소묘,획취746개정상슬관절도상수거.남214명,녀195명;년령17 ～ 65세,평균37.7세;좌슬374개,우슬372개.통과수직우고골궤계축선적단층도상진행슬관절중건,대축선삼수진행평면측량,포괄고골후과각、과뉴전각、림상상과축선여외과상과축선협각.안성별화측별진행분조,비교축선삼수적차이.결과 고골후과각평균위3.29°±1.24°、남성3.31°±1.30°、녀성3.26°±1.17°、좌슬3.24°±1.26°、우슬3.33°±1.22°,과뉴전각평균위7.06°±1.63°、남성7.02°±1.63°、녀성7.11°±1.63°、좌슬7.06°±1.68°、우슬7.06°±1.58°,불동성별급측별고골후과각급과뉴전각적차이무통계학의의;림상상과축선여외과상과축선협각평균위3.81°±1.14°、남성3.72°±1.11°、녀성3.91°±1.17°、좌슬3.83°±1.20°、우슬3.80°±1.08°,불동측별림상상과축선여외과상과축선협각적차이무통계학의의,불동성별림상상과축선여외과상과축선협각적차이유통계학의의,녀성대우남성.결론 통과교대양본적중국한족인군정상슬관절적영상학관찰화측량,득도상대준학적국인고골원단선전축선수거,종이정학지도수술조작.고골원단적선전대선응연합다충방법학정.
Objective To explore the distal femur rotational alignment in normal Chinese of Han nationality and investigate its clinical application.Methods 409 volunteers (214 males and 195 females) from Beijing,Hebei,Xinjiang and Chongqing,aged from 17 to 65 (37.7 in average) had undergone CT scan of their lower limbs.The CT scan images of 746 normal knees (374 left and 372 right knees) were obtained.With computer-assisted image processing and reconstruction,the correlative parameters,including posterior condylar angle (PCA),condylar twist angle (CTA),and the angle between clinical transepicondylar axis and surgical transepicondylar axis (CSA) were measured.The parameters of two groups between males and females,as well as left and fight sides were analyzed.Results PCA:3.29°±1.24° in average,3.31°±1.30° in males,3.26°±1.17° in females,3.24°± 1.26° in left knees and 3.33°± 1.22° in right knees.CTA:7.06°±1.63° in average,7.02°± 1.63° in males,7.11°± 1.63° in females,7.06°± 1.68° in left knees and 7.06°± 1.58° in right knees.CSA:3.81°± 1.14° in average,3.72°± 1.11 ° in males,3.91°± 1.17° in females,3.83°±1.20° in left knees and 3.80°±1.08° in right knees.There was no significant difference between males and females,as well as left and right side in terms of PCA and CTA.There was no significant difference between left and right side,while there was significant difference between males and females in terms of CSA.CSA was larger in females than in males.Conclusion The result of the distal femur rotational alignment in normal Han nationality obtained in this study is relatively accurate,which could make it more precise in total knee arthroplasty.Individual handling and different locating methods should be applied on the determination of distal femur rotational alignment in the surgery.