冠状面下肢力线X射线测量的最新进展

X-ray measurement of frontal lower limb alignment

背景:冠状面下肢力线对膝关节外科疾病的诊治具有重要意义,而如何准确测量与评价仍是研究的焦点。目的:综述冠状面下肢力线X射线测量的相关临床和基础研究进展。方法:由第一作者检索CNKI数据库和Pubmed数据库相关文献。中文检索词为"下肢全长,下肢力线,下肢轴线,膝关节";英文检索词为"lower limb alignment,knee alignment,lower limb formity,full length,HKA"。检索时间范围:1985年1月至2011年12月。广泛查阅与冠状面下肢力线X射线测量相关的摄片手段、测量方法及可靠性、解剖标志定位、影响因素等文献。最终纳入33篇文献进入结果分析。结果与结论:一次曝光成像技术获取下肢全长X射线片结合计算机辅助技术测量是评估冠状面下肢力线的有效手段。负重与非负重、下肢的旋转、膝关节的屈曲、解剖标志的选取等因素均会影响下肢力线的准确测量,应充分予以考虑。

BACKGROUND：Accurate and reliable measurement of frontal lower limb alignment on X-ray film is important for diagnosis and treatment of knee disease,while it is still controversial currently.OBJECTIVE：To summarize the clinical and basic research progress related to frontal lower limb alignment measurement on X-ray film.METHODS：A computer-base search was performed by the first author on CNKI database and PubMed database for the relate articles published from January 1985 to December 2011.The Chinese key words were ＂full length of the lower limb,lower limb alignment,lower limb axis,knee＂,and the English key words were ＂lower limb alignment,knee alignment,lower limb formity,full length,HKA＂.Articles related to film capture,measurement technique and its reliability,anatomic landmark and influencing factors of frontal lower limb alignment measurement on X-ray film were extensively reviewed.Finally,a total of 33 articles were included to review. RESULTS AND CONCLUSION：Full length lower limb X-ray film through one exposure combined with computer assisted measurement technique is an effective method for evaluating frontal lower limb alignment.Various influencing factors,such as weight bearing or not,rotation of lower limb,knee flexion and anatomic landmark location,should be considered in measurement.