年龄及性别对股骨近端解剖参数的影响及其临床意义

Anatomical parameters of proximal femur related to age and gender in healthy Chinese subjects

目的：探讨正常国人股骨近端参数的特点，为设计出更好的符合国人解剖特点的假体提供解剖学依据。方法随机挑选40～60岁及61～90岁的男性及女性成人共80名，按年龄及性别分成4组，每组各20名，拍摄标准髋关节前后位CR片，由PACS医学图像处理系统测量出股骨头直径、颈长、颈干角、偏心距、股骨头垂直高度、干骺端宽度T＋20、T、T-20、峡部直径、髓腔扩张指数、干骺端扩张指数等参数，总体数据与Noble等所测量的西方人相关数据进行比较，再在各组之间相互进行比较。结果正常成人股骨近端解剖数据与欧美人数据有多处存在差别，特别是偏心距、髓腔宽度、股骨头直径、CFI等方面。按性别及年龄进行比较，发现性别对解剖数据影响较大，另外年龄对女性的影响更加明显。结论建立股骨近端参数数据库，并依此设计出符合中国成人，特别是符合不同年龄及性别的国人的假体对提高假体使用寿命是十分必要的。

Objective To measure the anatomical parameters of the proximal femur in healthy Chinese subjects with dif-ferent ages and genders. Methods Healthy Chinese subjects randomly selected were divided into 4 groups with 20 cases in each group：young males （40-60y）, old males （60-90y）, young females （40-60y） and old females （60-90y）. Standard antero-posterior radiographs were prepared and the parameters were measured by PACS software. The parameters included diameter of femoral head, length of femoral neck, neck- shaft angle, offset, height of femoral head, the width of bone medul ary cavity at the plane of the lesser trochanter, 20mm above and below the lesser trochanter, diameter of the isthmus, canal flare index （CFI）, metaphyseal canal flare index （MCFI）. The parameters were compared between Chinese and Westerners and among each age and sex groups of Chinese subjects. Results There were significant differences in proximal femoral parameters between Chi-nese and westerners. There were significant differences between two genders in Chinese subjects and the aging affected the parameters significantly for females. Conclusion The database of proximal femora of healthy Chinese is important for design and manufacture of domestic prosthesis.