摘要
目的测量和研究桡骨近端解剖形态特点,为设计解剖型的桡骨头假体提供数据。方法对男、女各24例成年肱骨外上髁炎患者的肘关节进行MRI扫描,通过软件测量桡骨近端的解剖参数,包括桡骨头的直径与高度、桡骨头关节面深度、桡骨颈高度、桡骨颈髓腔狭窄处的直径等。采用SPSS16.0软件包进行数据统计,研究桡骨头近端各解剖参数间的相关关系。结果桡骨头最大直径(Rmax)及最小直径(Rmin)分别为[(23.1±5.3)mm,x±s,下同]和(21.8±5.0)mm,桡骨头高度(H1)及桡骨颈高度(Hn)分别为(11.3±2.3)mm和(11.8±4.8)mm,桡骨颈髓腔狭窄处最大直径(Dmax)和最小直径(Dmin)分别为(10.6±2.7)mm和(9.0±2.5)mm,桡骨头关节面最大深度(Dep)为(2.1±0.6)mm。男性桡骨头Rmax和Rmin分别为(25.1±4.2)mm和(23.7±4.0)mm,H1及心分别为(11.9±1.9)mm和(12.2±3.9)mm,Dmax及Dmin分别为(11.1±2.5)mm和(9.6±2.2)mm,Dep为(2.2±0.6)mm。女性Rmax和Rmin分别为(21.1±2.3)mm和(19.9±2.2)mm,H1及H2分别为(10.7±1.9)mm和(11.5±5.6)mm,Dmax和Dmin分别为(10.0±2.6)mm和(8.4±2.3)mm,Dep为(2.0±0.6)mm。男性和女性的各项指标相比,差异有统计学意义(P〈0.05)。Rmax和Rmin之间差异有统计学意义(P〈0.05),两者之间呈线性相关,相关关系为Rmin=0.95×Rmax。Dmax和Dmin之间差异有统计学意义(P〈0.05),两者之间呈线性相关,相关关系为Dmin=0.85×Dmax。桡骨头和桡骨颈髓腔大小之间以及桡骨头、颈高度之间的相关关系较为离散。结论桡骨近端解剖形态为椭圆形,圆形桡骨头假体设计不能很好地体现桡骨头的解剖特点,较少的选择余地和一体化的设计不能满足临床实际需要,而装配型假体能更灵活地应对各种临床变异情况。
Objective To measure and study the morphometric parameters of the proximal radius, and to provide the references for further anatomical design of the radial head prosthesis. Methods The MRIs of 24 male and 24 female adult patients with lateral epieondylitis were reviewed. The following parameters were measured from the axial, sagittal, and coronal images: (1) maximum and minimum diameters of the radial head (Rmax and Rmin), (2) radial head height (H1), (3) radial neck height (Hn), (4) maximum and minimum intramedullary diameters at the narrowest level of the radial neck (Dmax and Dmin), and (5) depth of the radial head surface (Dep). Statistical analysis (SPSS16.0) was performed to analyze the relationship among individual morphometric data. Results The maximum radial head diameter (Rmax) and the minimum radial head diameter (Rmin) were (23.1±5.3) mm and (21.8±5.0) mm respectively. The radial head height (H1) and radial neck height (Hn) were ( 11.3 ± 2.3) mm and ( 11.8 ± 4.8) mm on average. The maximum intramedullary diameter at the narrowest level of the radial neck(Dmax)and the minimum intramedullary diameter at the narrowest level of the radial neck(Dmin)averaged (10.6± 2.7) mm and (9.0± 2.5) mm. The depth of the radial head surface was (2.1 ±0.6) mm on average. Rmax and Rmin of male were (25.1 ± 4.2) mm and (23.7 ± 4.0) mm respectively, H1 and Hn( 11.9 ± 1.9) mm and ( 12.2 ± 3.9) nun respectively, Dmax and Dmin ( 11.1 ± 2.5) mm and (9.6 ± 2.2 ) nun respectively. The depth of the articular surface was (2.2 ± 0.6) mm. In female, Rmax and Rin were (21.1 ± 2.3) mm and (19.9±2.2) mm respectively, H1 and Hn (10.7± 1.9) mm and ( 11.5 ±1. 6 ) mm respectively, Dmax and Dmin ( 10.0 ± 2.6 ) mm and (8.4 ± 2.3) mm respectively, and the depth of the articular surface was (2.0 ± 0.6) ram. There were statistically significant differences between male and female radial head dimensions ( P 〈 0.05). Rmax and Rmin had a correlation of Rmin= 0.95 × Rmax; and there was a correlation between Dmax and Dmin with the formula Dmin = 0.85 × Dmin ( P 〈 0.05 ). The correlations between Rmax and Dmax, Rmax and H1, Rmax and Hn were more dispersed. Conclusion The radial head has an ellipse shape. The commercially available radial head prostheses can not precisely replicate normal anatomy.Modular implant system should be considered.
出处
《中华手外科杂志》
CSCD
北大核心
2009年第4期214-217,共4页
Chinese Journal of Hand Surgery
关键词
桡骨
假体
研究设计
核磁共振
Radius
Prosthesis
Research design
Nuclear magnetic resonance