CAJ | 학술논문

背景：人工全膝关节置换过程中股骨假体旋转定位良好是置换成功的关键之一，与置换后关节功能密切相关。股骨髁各项解剖参数也非常重要，熟悉其各项数据能够合理截骨以及选择轴线，避免假体安装位置不佳导致全膝关节置换后关节功能障碍。 　　目的：通过对股骨髁标本的解剖结构进行观察，测量股骨髁标本解剖参数及定位轴线之间的角度。 　　方法：固定架固定共40例股骨骨性标本，观察内上髁及外上髁形态变化，测量股骨髁解剖参数，包括长度、宽度等；应用定位导向器于内外上髁之间穿克氏针固定，垂直股骨后髁轴截骨后以万能角度量角器测量股骨4条轴线--手术髁上轴、临床髁上轴、后髁轴、AP轴之间的相关角度关系。 　　结果与结论：内上髁凹陷出现比例较低，约占所有标本比例总数的25%；股骨髁的高度与西方人相比差别不大，宽度与西方人相比差别较大。提示股骨髁宽度与西方人群差别较大，手术操作应充分注意；股骨髁内上髁凹陷出现比例不高，故参照髁上轴的后髁角定位只适用于部分人群；而 AP 轴较易定位，两条轴线与后髁轴线之间成角数值稳定，变异性较小，证实AP轴可做为股骨假体旋转定位的可靠标记。
배경：인공전슬관절치환과정중고골가체선전정위량호시치환성공적관건지일，여치환후관절공능밀절상관。고골과각항해부삼수야비상중요，숙실기각항수거능구합리절골이급선택축선，피면가체안장위치불가도치전슬관절치환후관절공능장애。 　　목적：통과대고골과표본적해부결구진행관찰，측량고골과표본해부삼수급정위축선지간적각도。 　　방법：고정가고정공40례고골골성표본，관찰내상과급외상과형태변화，측량고골과해부삼수，포괄장도、관도등；응용정위도향기우내외상과지간천극씨침고정，수직고골후과축절골후이만능각도량각기측량고골4조축선--수술과상축、림상과상축、후과축、AP축지간적상관각도관계。 　　결과여결론：내상과요함출현비례교저，약점소유표본비례총수적25%；고골과적고도여서방인상비차별불대，관도여서방인상비차별교대。제시고골과관도여서방인군차별교대，수술조작응충분주의；고골과내상과요함출현비례불고，고삼조과상축적후과각정위지괄용우부분인군；이 AP 축교역정위，량조축선여후과축선지간성각수치은정，변이성교소，증실AP축가주위고골가체선전정위적가고표기。
BACKGROUND:Good rotational location for femoral prosthesis is a key in total knee replacement, which is strongly associated with joint function after replacement. Each anatomical parameter of femoral condyle is also very important. To familiar with each data can do reasonably ostectomy and select axis, can avoid poor location of prosthesis-induced joint dysfunction after total knee replacement. OBJECTIVE:To observe the anatomical structure of femoral condyle specimens, and measure the angle between anatomical parameter and the axis. METHODS:A total of 40 femoral bone specimens were fixed on the frame. Morphological changes in the medial epicondyle and the lateral epicondyle were observed. Femoral condyle parameters, including length and width, were measured. Kirschner wire was used between the medial epicondyle and the lateral epicondyle using a targeting device. After ostectomy, four axial lines were measured with a conimeter, including surgical epicondylar axis, clinical epicondylar axis, posterior condylar line and anterior-posterior axis. RESULTS AND CONCLUSION:The depression of medial epicondyle appeared relatively low, accounting for 25%of the total number of al specimens;the height of the femoral condyle did not have significant difference compared with westerners, but width was smal er compared with westerners. Thus, the surgeons should be ful y aware of the width of femoral condyle in operative procedures. The appearance of depression of medial epicondyle was not frequent, so posterior condylar angle of epicondylar axis was only fit for some persons. However, anterior-posterior axis was easily to be located. The angle between two axes and posterior condylar line was stable, and variability was smal . Thus, the anterior-posterior axis can be used as a reliable label for rotational position of femoral prosthesis.