摘要
目的通过CT三维重建,模拟验证后侧皮质线作为人工全髋关节置换术中股骨柄前倾参照的有效性。方法接受双侧髋关节至双侧的股骨髁CT扫描病人43例。经Mimics软件三维重建后,在股骨颈水平横断面及不同斜行截骨面上测量皮质中间线、T线及后侧皮质线前倾角,并同股骨颈自然前倾角比较。结果股骨颈自然前倾角平均值为(15.8±4.9)°。在水平横断面上,T线前倾角与后侧皮质线前倾角比较差异无统计学意义(P>0.05),骨皮质中间线前倾角与T线前倾角、骨皮质中间线前倾角及后侧皮质线前倾角比较差异有统计学意义(P<0.05)。在不同高度斜行截骨面上,骨皮质中间线前倾角与T线前倾角、骨皮质中间线前倾角及后侧皮质线前倾角比较差异均有统计学意义(P<0.05),而T线前倾角与后侧皮质线前倾角差异则无统计学意义(P>0.05)。股骨颈水平横断面与不同高度斜行截骨面水平,骨皮质中间线前倾角、T线前倾角和后侧皮质线前倾角比较差异均无统计学意义(P>0.05)。结论人工全髋关节置换术中,斜行截骨切面上的后侧皮质线可以作为股骨柄植入前倾方向的参考。
Objective To simulation verify the validity of posterior cortical line of the femoral cross section as a reference to the anterior inclination of femur in total hip arthroplasty（THA） by CT 3-D reconstruction. Methods A total of 43 cases received bilateral hip and femoral condylar lever CT scan. After 3-D reconstruction by Mimics software, mid-cortical line, T-line and posterior cortical line antever- sion at the femoral neck transverse slide and different height of oblique osteotomy surface were measured. The data were compared with femoral neck native anteversion. Result Mean of natural anterior inclina- tion of femoral neck was（ 15.8 ±4.9）°. On the femoral neck transverse level,there is no difference be- tween anterior inclination of T-line and posterior cortical line （P 〉 0.05 ）. Statistic difference exist between mid-cortical line and T line （ P 〈 0.05 ）, mid-cortical line and posterior cortical line （ P 〈 0.05 ）. On differ- ent height of oblique osteotomy surface, there are statistic difference between mid-cortical line and T-line, mid-cortical line and posterior cortical line （P 〈 0.05 ）, but no difference between T-line and posterior cor- tical line （ P 〉 0.05 ）. When compare between transverse level and different height oblique level, there were statistic difference among mid-cortial line（P 〉 0.05 ） ,T line（ P 〉 0.05 ）and posterior cortical line （P 〉 0.05）. Conclusion Posterior cortical line on the real oblique osteotomy surface was an effective reference for stem insertion during THA.
作者
张磊
李皓桓
唐金明
陈文革
杨朝晖
ZHANG Lei;LI Haohuan;TANG Jinming(Department of Orthopedic Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《临床外科杂志》
2018年第8期594-597,共4页
Journal of Clinical Surgery
关键词
股骨颈前倾角
骨皮质中间线
T线
后侧皮质线
股骨自然前倾角
femoral neck anteversion
mid cortical line
T-line
posterior cortical line
native femoral anteversion
