摘要
目的:探讨骨质疏松时股骨上段髓腔的形态学变化,为老年人工髋关节置换术提供依据。方法:160根股骨,每个标本分别拍照正位、侧位、45°内斜位和45°外斜位的X线片,记录Singh指数,测量股骨上段髓腔,研究Singh指数和股骨上段髓腔的关系。结果:Singh指数为7￣5的62个标本中髓腔扩大者6.5%(4),不扩大者93.5%(58);Singh指数为4￣1的95个标本中髓腔扩大者67.4%(64),不扩大者32.6%(31);Singh指数越大,股骨上段髓腔越窄,Singh指数越小,股骨上段髓腔越宽大;骨质疏松时股骨髓腔扩大是全方位的,其骨皮质吸收以髓腔内面明显。结论:(1)骨质疏松标本髓腔扩大峡部不明显,假体设计要考虑到峡部不明显时如何使股骨柄远端与股骨骨髓腔形态相匹配,对老年人可将柄下端适当加粗,以适应髓腔变化。(2)对骨质疏松老年人,选择假体前要拍照股骨全长的正、侧位及双斜位X线片,对髓腔形态有较全面的评估,以选择适合的假体。
Objective： To explore the morphological features of the proximal femur canal of osteoporosis and provide data for hip replacement of elder people. Methods： 160 femora without osseous pathology, previous fractures or the presence of defect were obtained. After labeling and recording, each specimen was taken the anteroposterior, lateral, inner oblique at 45° and outer oblique at 45° X-ray. Standard periosteal （extra cortical） and endosteal （intm cortical） dimensions were determined through direct measurement on each roentgenogram. At the level of 20mm above or below the center of lesser trochanter, the proximal border of isthmus, the distal border of isthmus, the Singh index was determined according to the morphological features of every femur. The relationship between the Singh index and dimensions was evaluated. Results： 4 cases of 62 （6.5%） with Singh index of 7-5, and 64 cases of 95 （67.4%） with Singh index of 4-1, showed dilated medullary cavity. The more greater of the index, the more narrower of the proximal femoral canal. Suffering from the osteoporosis, the canal dilated completely, and cortical bone of the inner surface of canal absorbed obviously. Conclusions： The isthmus of the canal in the osteoporosis specimen has enlargement. The importance of a close match between the medullary canal and the femoral components was emphasized for osteoporosis cases because the shape of the isthmus. Instruments may be designed with enlarged lower part of the stem. X-ray film about the whole thigh bone must be taken at different position so that the whole medullary canal of femur can be estimated and the change of the cortex can be noticed before operation
出处
《中国临床解剖学杂志》
CSCD
北大核心
2006年第6期631-633,共3页
Chinese Journal of Clinical Anatomy
基金
北京市科委资助项目(H010410030112)
关键词
股骨
髓腔
骨质疏松
人工髋关节
femur
femoral canal
osteoporosis
artificial hip joint
