髌骨脱位与髌骨Wiberg形态学分型回顾性研究

A retrospective study of patellar dislocation and patellar Wiberg's morphological classification

目的探讨髌骨Wiberg分型与髌骨脱位的相关性。方法回顾性分析2010年1月至2012年6月门诊及住院髌骨脱位患者43例(48膝),男性22例,女性21例。采集膝关节CT扫描的Dicom3.0格式图像数据,利用Mimics 10.01软件转换成STL格式的三维立体图像,然后将STL文件导入Imageware软件,观察髌骨Wiberg形态学分型并测量髌骨倾斜角。结果 WibergⅡ型、Ⅲ型髌骨在男性和女性的分布分别为14膝、10膝和13膝、11膝,髌骨脱位患者无性别差异(P>0.05)。Wiberg分型总体分布不均匀,Ⅱ型>Ⅲ型>Ⅰ型(P<0.05)。Ⅱ型、Ⅲ型髌骨的髌骨倾斜角分别为22.6°±7.1°和27.3°±8.1°,Ⅲ型髌骨的髌骨倾斜度明显大于Ⅱ型髌骨(P<0.05)。结论Ⅰ型髌骨最稳定;髌骨脱位患者中以Ⅱ型、Ⅲ型髌骨居多,Ⅱ型髌骨较Ⅲ型髌骨更稳定;髌骨倾斜角大于20°的Ⅱ型、Ⅲ型髌骨容易发生脱位。

Objective To explore the correlation of patellar Wiberg＇s classification and patellar dislocation. Methods We reviewed 43 patients （48 knees） of patella dislocation from January 2（110 to June 2012 in our department, including 22 males and 21 females. Dicom 3.0 format image data collected from these 54 knees were obtained by CT scan, and then were transformed by the Mimics 10. 01 software to achieve three-dimensional data of STL format. The STI. file was further imported into the software Imageware to observe Wiberg＇s classification of patellar and measure patellar tilt angle. Results There were 14 knees of type Ⅱ and 10 knees of type Ⅲ in males, and the corresponding cases in females were 13, 11 respectively. There was no significant difference between male and female （P〉0.05）, and distribution of Wiberg＇s classification was overall uneven, type Ⅱ〉 Ⅲ 〉I （P〈0.05）. The patellar tilt angle of type Ⅱ and Ⅲ were 22.6°± 7. 1°and 27.3°± 8. lrespectively, the patellar tilt angle of type m was significantly bigger than type Ⅱ（P〈0. 05）. Conclusions Type I patella is the most stable one, while type Hand Ⅲcombines the majority of patellar dislocation cases, in which type Ⅱ has a better stability. Patella tilt angle larger than 20°have higher propensity of patellar dislocation in type Ⅱ and Ⅲ.