中医正骨
中醫正骨
중의정골
The Journal of Traditional Chinese Orthopedics and Traumatology
2015年
10期
11-14
,共4页
前交叉韧带重建%关节镜检查%体层摄影术,X 线%股骨隧道定位
前交扠韌帶重建%關節鏡檢查%體層攝影術,X 線%股骨隧道定位
전교차인대중건%관절경검사%체층섭영술,X 선%고골수도정위
anterior cruciate ligament reconstruction%arthroscopy%tomography,X-ray%femoral tunnel positioning
目的：探讨应用 X 线片评估前交叉韧带（anterior cruciate ligament，ACL）单束解剖重建术股骨隧道定位的可行性。方法：选取57例因 ACL 断裂接受 ACL 单束解剖重建术的患者，在术后患侧膝关节标准正位片上测量股骨髁长度 ML、移植物股骨止点至股骨外髁外缘的距离 NL 及膝关节线与股骨隧道中心线的夹角α，在侧位片上测量 Blumensaat 线的长度 BL、移植物股骨止点至股骨髁间凹顶的距离 AL 及股骨干长轴与股骨隧道中心线的夹角β，以 X 线片上移植物股骨端在髁间窝处的中心点作为移植物股骨止点。为消除 X 线片放大率的影响，将所测得的长度转换成百分数，以 NL／ML ×100％表示移植物股骨止点在正位片上的位置，AL／BL ×100％表示移植物股骨止点在侧位片上的位置。将所测数据（解剖重建组）与我们以往采用 ACL 单束解剖重建术治疗并完成随访的47例患者的数据进行比较；47例患者均已采用国际膝关节文献委员会（the international knee documentation com-mittee，IKDC）膝关节韧带损伤评分量表评定疗效，其中38例 IKDC 评分＞90分（IKDC ＞90分组），9例 IKDC 评分＜90分（IKDC ＜90分组）。结果：解剖重建组 NL／ML ×100％、AL／BL ×100％、α角及β角分别为（55．71±4．78）％、（30．13±5．26）％、47．90°±3．57°、29．50°±4．52°。解剖重建组和 IKDC ＞90分组 NL／ML ×100％、AL／BL ×100％、α角及β角比较，组间差异均无统计学意义（t ＝1．201，P ＝0．233；t ＝0．389，P ＝0．698；t ＝1．879，P ＝0．063；t ＝1．803，P ＝0．075）。解剖重建组与 IKDC ＜90分组的 NL／ML ×100％比较，差异无统计学意义（t ＝1．511，P ＝0．136）；解剖重建组的 AL／BL ×100％、α角及β角均小于 IKDC ＜90分组（t ＝9．067，P ＝0．000；t ＝15．361，P ＝0．000；t ＝6．967，P ＝0．000）。结论：通过在术后 X 线片上进行测量，可评估 ACL 单束解剖重建术股骨隧道定位的准确性。
目的：探討應用 X 線片評估前交扠韌帶（anterior cruciate ligament，ACL）單束解剖重建術股骨隧道定位的可行性。方法：選取57例因 ACL 斷裂接受 ACL 單束解剖重建術的患者，在術後患側膝關節標準正位片上測量股骨髁長度 ML、移植物股骨止點至股骨外髁外緣的距離 NL 及膝關節線與股骨隧道中心線的夾角α，在側位片上測量 Blumensaat 線的長度 BL、移植物股骨止點至股骨髁間凹頂的距離 AL 及股骨榦長軸與股骨隧道中心線的夾角β，以 X 線片上移植物股骨耑在髁間窩處的中心點作為移植物股骨止點。為消除 X 線片放大率的影響，將所測得的長度轉換成百分數，以 NL／ML ×100％錶示移植物股骨止點在正位片上的位置，AL／BL ×100％錶示移植物股骨止點在側位片上的位置。將所測數據（解剖重建組）與我們以往採用 ACL 單束解剖重建術治療併完成隨訪的47例患者的數據進行比較；47例患者均已採用國際膝關節文獻委員會（the international knee documentation com-mittee，IKDC）膝關節韌帶損傷評分量錶評定療效，其中38例 IKDC 評分＞90分（IKDC ＞90分組），9例 IKDC 評分＜90分（IKDC ＜90分組）。結果：解剖重建組 NL／ML ×100％、AL／BL ×100％、α角及β角分彆為（55．71±4．78）％、（30．13±5．26）％、47．90°±3．57°、29．50°±4．52°。解剖重建組和 IKDC ＞90分組 NL／ML ×100％、AL／BL ×100％、α角及β角比較，組間差異均無統計學意義（t ＝1．201，P ＝0．233；t ＝0．389，P ＝0．698；t ＝1．879，P ＝0．063；t ＝1．803，P ＝0．075）。解剖重建組與 IKDC ＜90分組的 NL／ML ×100％比較，差異無統計學意義（t ＝1．511，P ＝0．136）；解剖重建組的 AL／BL ×100％、α角及β角均小于 IKDC ＜90分組（t ＝9．067，P ＝0．000；t ＝15．361，P ＝0．000；t ＝6．967，P ＝0．000）。結論：通過在術後 X 線片上進行測量，可評估 ACL 單束解剖重建術股骨隧道定位的準確性。
목적：탐토응용 X 선편평고전교차인대（anterior cruciate ligament，ACL）단속해부중건술고골수도정위적가행성。방법：선취57례인 ACL 단렬접수 ACL 단속해부중건술적환자，재술후환측슬관절표준정위편상측량고골과장도 ML、이식물고골지점지고골외과외연적거리 NL 급슬관절선여고골수도중심선적협각α，재측위편상측량 Blumensaat 선적장도 BL、이식물고골지점지고골과간요정적거리 AL 급고골간장축여고골수도중심선적협각β，이 X 선편상이식물고골단재과간와처적중심점작위이식물고골지점。위소제 X 선편방대솔적영향，장소측득적장도전환성백분수，이 NL／ML ×100％표시이식물고골지점재정위편상적위치，AL／BL ×100％표시이식물고골지점재측위편상적위치。장소측수거（해부중건조）여아문이왕채용 ACL 단속해부중건술치료병완성수방적47례환자적수거진행비교；47례환자균이채용국제슬관절문헌위원회（the international knee documentation com-mittee，IKDC）슬관절인대손상평분량표평정료효，기중38례 IKDC 평분＞90분（IKDC ＞90분조），9례 IKDC 평분＜90분（IKDC ＜90분조）。결과：해부중건조 NL／ML ×100％、AL／BL ×100％、α각급β각분별위（55．71±4．78）％、（30．13±5．26）％、47．90°±3．57°、29．50°±4．52°。해부중건조화 IKDC ＞90분조 NL／ML ×100％、AL／BL ×100％、α각급β각비교，조간차이균무통계학의의（t ＝1．201，P ＝0．233；t ＝0．389，P ＝0．698；t ＝1．879，P ＝0．063；t ＝1．803，P ＝0．075）。해부중건조여 IKDC ＜90분조적 NL／ML ×100％비교，차이무통계학의의（t ＝1．511，P ＝0．136）；해부중건조적 AL／BL ×100％、α각급β각균소우 IKDC ＜90분조（t ＝9．067，P ＝0．000；t ＝15．361，P ＝0．000；t ＝6．967，P ＝0．000）。결론：통과재술후 X 선편상진행측량，가평고 ACL 단속해부중건술고골수도정위적준학성。
Objective:To explore the feasibility of roentgenologic evaluation of femoral tunnel positioning in anterior cruciate ligament (ACL)single -bundle anatomical reconstruction.Methods:Fifty -seven patients who received ACL single -bundle anatomical reconstruc-tion for treatment of ACL rupture were selected.After the surgery,the length of femoral condyle(ML),the distance between femoral ending point of graft and lateral border of femoral lateral condyle(NL)and the angle(α)between the knee -joint line and the centre line of femoral tunnel were measured on the standard anteroposterior X-ray film of affected knee;while the length of Blumensaat line(BL),the distance be-tween femoral ending point of graft and the top of femoral intercondyloid fossa(AL)and the angle(β)between the macroaxis of femoral shaft and the centre line of femoral tunnel were measured on the lateral X-ray film,with use of the central point of femoral ends of graft in inter-condyloid fossa on the X-ray film as femoral ending point of graft.In order to eliminate the influence of magnification of X-ray film,above lengths were converted into percentage.NL/ML ×100%represented the location of femoral ending point of graft on the anteroposterior X-ray film,and AL/BL ×100%represented the location of femoral ending point of graft on the lateral X-ray film.Then the data(anatomic recon-struction group)were compared with previous data of 47 patients who were treated with ACL single bundle anatomical reconstruction and completed the follow-up visit.The therapeutic effects had been evaluated in the 47 patients by using the knee ligament injury rating scale is-sued by the international knee documentation committee(IKDC),the IKDC score of >90 points was found in 38 patients(IKDC >90 points group)and the IKDC score of <90 points was found in 9 patients(IKDC <90 points group).Results:NL/ML ×100%,AL/BL × 100%,angle αand angle βin anatomic reconstruction group were 55.71 +/-4.78%,30.13 +/-5.26%,47.90 +/-3.57 degrees and 29.50 +/-4.52 degrees respectively.There was no statistical difference in NL/ML ×100%,AL/BL ×100%,angle αand angle βbetween anatomic reconstruction group and IKDC >90 points group(t =1.201,P =0.233;t =0.389,P =0.698;t =1.879,P =0.063;t =1.803, P =0.075).There was no statistical difference in NL/ML ×100% between anatomic reconstruction group and IKDC <90 points group(t =1.511,P =0.136).AL/BL ×100%,angle αand angle βwere less in anatomic reconstruction group compared to IKDC <90 points group (t =9.067,P =0.000;t =15.361,P =0.000;t =6.967,P =0.000).Conclusion:The accuracy of femoral tunnel positioning in surgery of ACL single -bundle anatomical reconstruction can be evaluated through measuring on the X-ray film after the surgery.
