股骨髓腔前弓形态性别差异及与假体柄设计的关系

Gender difference of the anterior bow of femoral medullary and its relation with the design of femoral prothesis

目的 在CT三维重建辅助条件下测量股骨髓腔前弓形态的解剖参数,为设计适合国人的股骨柄假体提供依据.方法 对105例正常国人股骨进行左侧股骨全长扫描,并利用图像分析软件对股骨髓腔前弓进行参数测量.结果 股骨髓腔长度、股骨前弓顶点至小粗隆平面长度男性均大于女性,差异有统计学意义（P＜0.001）；而股骨前弓顶点的位置指数男女差异无统计学意义（P＞0.05）；女性股骨前弓相对曲率大于男性,差异有统计学意义（P＜0.001）.股骨前弓顶点的弓高和髓腔长度（弦长）无显著相关性（r=0.106,P=0.281）.结论 男女性之间股骨前弓解剖形态存在一定差别,髋关节置换手术时应选择合适长度的股骨柄,并且有必要根据这些差别设计适合不同性别的股骨柄假体.

Objective To measure the parameters of anterior bow of the femoral medullary cavity by means of 3D spiral CT reconstruction and to provide the anatomical basis for the design of the femoral component prosthesis.Methods 105 healthy Chinese left femurs were scanned in standard neutral position by 3D spiral CT.Parameters of the anterior bow of the femoral medullary were measured by medical imagine software.Results The parameter values of the male femur were statistically bigger than those of the female,including the length of the femoral medullary and the distance from the point of maximum curvature to plane above lesser trochanter （P〈0.001）.No significant differences between male and female in the position index of the point of maximum curvature were observed （P〉0.05）.The relative curvature of the female femoral anterior arch was statistically bigger than that of the male （P〈0.001）.The femoral curvature subtense and the length of the femoral medullary showed no significant correlation （r=0.106,P=0.281）.Conclusion There are certain anatomic differences in the anterior bow of the femoral medullary between male and female.Appropriate length of femoral component should be considered in total hip replacement operation.And it is necessary to design the femoral components fitting the features of the femurs according gender difference.