胫骨近端后侧数字化三维形态学测量及临床意义

The three-dimensional measurements and clinical significance of the morphology of posterior proximal tibia

目的研究胫骨近端后侧数字化形态学测量的方法,探讨其对胫骨后侧平台骨折诊疗的意义。方法对60例健康成人胫骨干燥标本进行CT扫描,图像导入Mimics 10.01软件建立数字化三维模型,测量相关解剖参数,分析其分布规律与相关关系。结果后侧正中高度(8.46±1.62)mm,后内侧高度(12.27±1.93)mm,后内侧斜坡长度(14.71±2.27)mm,后内侧平台斜坡角(132.02±11.62)°,后内侧斜坡骨干角(147.28±10.72)°,后外侧高度(11.31±1.74)mm,后外侧斜坡长度(14.45±2.26)mm,后外侧平台斜坡角(124.01±9.81)°,后外侧斜坡骨干角(141.88±9.09)°,所有测量参数双侧差异无统计学意义(P>0.05)。后正中高度、后外侧高度和后外侧斜坡长度与胫骨全长具有相关性(P<0.01)。结论本研究建立的胫骨近端数字化三维模型仿真度高,解剖参数测量结果精确度高,能为胫骨后侧平台骨折临床治疗和内固定物设计提供解剖学依据。

Objective To study the methods of digital measurement of the morphology of posterior proximal tibia and to investigate the significance in the treatment of tibial plateau fractures. Methods Tomographic images of 60 healthy human tibial specimens were obtained by CT scans and imported into the Mimics 10.01 software for 3D reconstruction. Then the related anatomical parameters were measured and analyzed. Results The posterior central height was （8.46 ± 1.62）mm, the posteromedial height was （12.27 ± 1.93）mm, the posteromedial slope length was （14.71 ± 2.27）mm, the posteromedial plateau-slope angle was （132.02±11.62）°, the posteromedial slope-diaphysis angle was （147.28±10.72）°, the posterolateral height was （11.31 ± 1.74）mm, the posterolateral height was （14.45 ± 2.26）mm, the posterolateral plateau-slope angle was （124.01 ± 9.81）° and the posterolateral slope-diaphysis angle was （141.88 ± 9.09）° . There were no statistically significant differences between different sides（P〉0.05）. The Posterior central height, the posterolateral height and the posterolateral height were correlated to the total length of tibia（P〈0.01）. Conclusion The three-dimensional reconstruction model has a high fidelity and a high accuracy in anatomical measurement. It can provide anatomical references in the clinical managements and implants designing of posterior tibial plateau fractures.