华南地区正常成人股骨远端髁扭转角测量及其临床意义

Measurement of femoral condylar twist angle in adults of South China and its clinical significance

目的探讨华南地区正常成人的膝关节股骨远端髁扭转角具体数值,并分析其在性别和侧别间有无统计学差异。方法招募华南地区(往上数五代以内均生在华南地区,包括广东、广西或者海南)正常成人志愿者71例(142膝),男38例(76膝),女33例(66膝),年龄20～45岁,平均30.56岁,体重40～80kg,平均59.90kg,身高151～185cm,平均167.80cm。通过螺旋CT扫描志愿者膝关节,所得原始数据(DICOM3)刻录为光盘,导入MIMICS10.01中,选择通过股骨内外上髁的层面进行测量股骨远端髁扭转角。结果所测得华南地区正常成人的股骨远端髁扭转角:男性为(6.20°±2.03°),女性为(7.19°±1.78°),均值为(6.66°±1.97°),性别之间差异有统计学意义(t=3.077,P<0.01);左侧为(6.86°±1.92°),右侧为(6.45°±2.02°),侧别间无统计学差异(t=1.238,P>0.05)。总体股骨远端髁扭转角为(2.39°～11.34°),均值(6.66°±1.97°)。结论对华南人的人工全膝关节置换术中,传统的外旋3°截骨可能会导致对线不佳,应该适当提高旋转对线的外旋度数。

Objective To measure the femoral condylar twist angle in the adults of South China. Methods 71 adult volunteers （ 142 knees） in South China were enrolled, among which there were 38 males （76 knees） and 33 females （66 knees） , with an average age of 30. 56 years （ ranging from 20 to 45 years） , an average weight of 59. 90 kg （ ranging from 40 to 80kg） and an average height of 167.80 cm （ranging from 151 to 185 cm）. All knees were scanned by spiral CT, the data were imported to MIMICS 10.01, then the femoral condylar twist angle was measured at the plane of the internal and external femoral condyles. Results Femoral condyle reverse angles in the adults of South China were as follows： （6. 20° ± 2.03 °） in male, （7.19° ± 1.78 °） in female; the femoral condylar twist angle of female was significantly larger than that of male （t =3. 077, P 〈0. 01 ） ; the twist angles were （6. 86° ± 1.92°） on the left side, and （6. 45°± 2. 02°） on the right side; there was no statistically significant difference between different sides （ t = 1. 238, P 〉 0. 05 ）. Overall mean value was （6. 66° ± 1.97° ）, ranging from 2. 39° to 11.34°. Conclusions The traditional osteotomy with 3° external rotation may lead to malalignment in adults of South China. The angle should be reasonably increased.