动力髁螺钉治疗股骨远端骨折的应用解剖

Applied anatomy on the treatment of distal femoral fracture with dynamic condylar screw

目的为临床应用动力髁螺钉治疗股骨远端骨折提供解剖学数据。方法 (1)男女性股骨标本各30根,测量股骨髁宽、内侧髁宽、外侧髁宽、内侧髁前后径、外侧髁前后径、股骨内侧髁倾角、股骨外侧髁倾角等数值。(2)X线摄片30位正常成年志愿者股骨,进行冠状面上角度测量。结果股骨髁宽、内侧髁髁宽、外侧髁髁宽、内侧髁前后径、外侧髁前后径等值均有显著的性别差异(P<0.01),同性别内侧髁倾角明显大于外侧髁倾角(P<0.01)。股骨干与股骨远侧段之间的夹角、股骨干与股骨近侧段之间的夹角、股骨干与膝关节面之间的夹角存在性别差异(P<0.01～P<0.05)。股骨远侧段与股骨近侧段的夹角不存在显著的性别差异(P>0.05)。结论动力髁螺钉手术中应注意股骨髁形态的性别差别和股骨远侧段存在的弯曲,以提高动力髁螺钉治疗股骨远端骨折的手术效果。

Objective To provide anatomic data for clinical application of dynamic condylar screw.Methods（1）30 male and female femur specimens were collected in this study.The widths of femoral condyles,medial and lateral condyles,the anteroposterior diameters of medial and lateral condyles,and the slope angles of medial and lateral femoral condyles,were measured respectively.（2）The femur X-ray images of 30 normal adult volunteers were collected and measured on coronal plane.Results The width of femoral condyles,and dedial and lateral condyles,the anteroposterior diameters of the medial and lateral condyles,presented the significant gender differences（P0.01）.The slope angles of homosexual medial femoral condyle were apparently greater than that of lateral condyle（P0.01）.The angles between femoral shaft and the distal end,femoral shaft and proximal end,femoral shaft and knee articular facet,had gender differences（P0.01~P0.05）.The angle between femur distal and proximal ends had no gender difference（P0.05）.Conclusions During the surgery of dynamic condylar screw,it is necessary for improving operational effects by paying attention to the sex differences of anatomic features of femurs.