CAJ | 학술논문

目的通过影像学测量腓骨小头上区域的相关数据,以验证腓骨小头上入路方式的可行性并设计相应的解剖钢板. 方法选择健康自愿者38名(共60膝),男22名(38膝),女16名(22膝);年龄18～60岁,平均44.8岁.分别按性别和身高2种方式分组:按性别分为A1组(男,38膝)和A2组(女,22膝);按身高分为B1组(156 ～ 170 cm,23膝)和B2组(171 ～ 185 cm,37膝).将60膝进行CT扫描并三维重建,将外侧平台三维CT图像分为3区:Ⅰ区为胫骨平台后外侧髁区域,Ⅱ区为腓骨小头上区域,Ⅲ区为胫骨前外侧区域,并测量腓骨小头关节面至胫骨外侧平台关节面的骨性区域数据.同时进行MRI扫描,测量胫骨外侧骨面与外侧副韧带之间的骨-韧带区域数据,将获取的数据进行相关分析. 结果骨性区域最窄宽度平均为(11.13±1.43) mm,骨-韧带区域最窄宽度平均为(5.35±0.78)mm.腓骨小头上区域测量结果显示:A1组骨性区域最窄宽度[(11.45±1.48) mm]较A2组[(10.58±1.34) mm]宽;B1组[(10.32±1.40) mm较B2组(11.63±1.45) mm]窄,差异均有统计学意义(P＜0.05).而骨-韧带区域最窄宽度A1组[(5.45 ±0.82) mm]与A2组[(5.18±0.71)mm]、B1组[(5.11 ±0.74) mm]与B2组[(5.50±0.80) mm]比较差异均无统计学意义(P＞0.05).结论腓骨小头上区域存在骨性空间及骨-韧带空间,可以设计腓骨小头上入路,胫骨外侧平台三维CT分区及各区数值对腓骨小头上入路解剖钢板的研制具有重要的指导意义.
목적 통과영상학측량비골소두상구역적상관수거,이험증비골소두상입로방식적가행성병설계상응적해부강판. 방법 선택건강자원자38명(공60슬),남22명(38슬),녀16명(22슬);년령18～60세,평균44.8세.분별안성별화신고2충방식분조:안성별분위A1조(남,38슬)화A2조(녀,22슬);안신고분위B1조(156 ～ 170 cm,23슬)화B2조(171 ～ 185 cm,37슬).장60슬진행CT소묘병삼유중건,장외측평태삼유CT도상분위3구:Ⅰ구위경골평태후외측과구역,Ⅱ구위비골소두상구역,Ⅲ구위경골전외측구역,병측량비골소두관절면지경골외측평태관절면적골성구역수거.동시진행MRI소묘,측량경골외측골면여외측부인대지간적골-인대구역수거,장획취적수거진행상관분석. 결과 골성구역최착관도평균위(11.13±1.43) mm,골-인대구역최착관도평균위(5.35±0.78)mm.비골소두상구역측량결과현시:A1조골성구역최착관도[(11.45±1.48) mm]교A2조[(10.58±1.34) mm]관;B1조[(10.32±1.40) mm교B2조(11.63±1.45) mm]착,차이균유통계학의의(P＜0.05).이골-인대구역최착관도A1조[(5.45 ±0.82) mm]여A2조[(5.18±0.71)mm]、B1조[(5.11 ±0.74) mm]여B2조[(5.50±0.80) mm]비교차이균무통계학의의(P＞0.05).결론 비골소두상구역존재골성공간급골-인대공간,가이설계비골소두상입로,경골외측평태삼유CT분구급각구수치대비골소두상입로해부강판적연제구유중요적지도의의.
Objective To measure the radiological data of the fibular capitellum which can be used for design of a surgical approach and an anatomical plate for the fibular capitellum.Methods Enrolled in the present study were 38 healthy volunteers (60 normal knees),including 22 males (38 knees) and 16 females (22 knees).They were aged from 18 to 60 years (average,44.8 years).They were divided into 2 groups twice according to gender and body height.Group A1 was males while group A2 females; group B1 included subjects of 156 to 170 cm in height while B2 subjects of 171 to 185 cm in height.The 60 knees were subjected to CT scan before three-dimensional (3-D) reconstruction for measurements of the bony region from the articular surface of the capitellum to the articular surface of the lateral tibial plateau.The 3-D CT images of the lateral tibial plateau were divided into 3 categories:division Ⅰ covering the posterolateral condyle of the tibial plateau,division Ⅱ covering the superior region of the capitellum and division Ⅲ covering the anterolateral region of the tibia.At the same time,the 60 knees were examined by MRI scanning to measure the bone-ligament region from the lateral tibial plateau to the lateral collateral ligaments.All the data were analyzed and compared.Results The narrowest width of the bony region was 11.13 ± 1.43 mm; the narrowest width of the bone-ligament region was 5.35 ± 0.78 mm.In division Ⅱ,the narrowest width of the bony region in group A1 (11.45 ± 1.48 mm) was significantly longer than in group A2 (10.58 ± 1.34 mm),but that in group B1 (10.32 ± 1.40 mm) was significantly shorter than in group B2 (11.63 ± 1.45 mm) (P ＜ 0.05).The narrowest width of the bone-ligament region in division Ⅱ was 5.45 ± 0.82 mm in group A1,showing no significant difference from that in group A2 (5.18 ±0.71 mm),B1 (5.11 ±0.74 mm) and B2 (5.50 ±0.80 mm) (P ＞ 0.05).Conclusions The bony space and bone-ligament space in the superior region of the fibular capitellum provide an anatomic basis for design of a superior fibular capitellum approach.The 3-D CT divisions of the lateral tibial plateau and their anatomic measurements are very important for development of an anatomical plate via the superior fibular capitellum approach.