股骨近端相关影像解剖学测量研究

The research of relevant image anatomy measurements of the proximal segment of femur

目的目的通过CT三维重建测量正常国人老年股骨近端的相关形态参数,为设计股骨近端内固定系统提供解剖学依据。方法对60位老年国人的股骨近端进行CT扫描,利用自带的医学图像处理软件进行三维重建,标定相关解剖标志,测量指标包括股骨小转子、股骨颈干角、股骨头偏心距以及股骨髓腔等相关解剖参数。结果所有测量参数左、右侧均无统计学差异(P>0.05),其中小转子纵径为(26.80±2.53)mm,横径为(16.09±1.72)mm,小转子高度为(8.41±1.50)mm,小转子体积为(727.15±165.18)mm3,拟固定小转子最短螺钉长度为(46.77±2.70)mm,应用上倾角为(16.83±2.06)°,股骨颈干角为(131.42±8.03)°,股骨头偏心距为(37.85±7.02)mm。结论 CT三维重建图像可精确识别股骨相应的解剖标志并进行解剖学测量,测量数据对老年转子间骨折的治疗和新型解剖锁定钢板的设计有参考价值。

Objective To obtain the morphological parameters of the proximal segment of the femur in Chinese healthy senior population through three-dimensional reconstruction of CT images of the femur in order to provide the anatomical basis for the design of the proximal femoral internal fixation system. Method The CT scan data of the proximal segment of the femur of 60 Chinese healthy senior personswas obtained and the three-dimensional reconstruction of the femur was performed using the system’s default software. The bony landmarks were determined on the three-dimensional images of the normal femur. Measurement included the anatomic indexes of the lesser trochanter, neck shaft, angle, femoral offset and femoral canal, etc. Results There was no statistically significant difference of all measurement parameters between the left side and the right side （P〉0.05）, and length of the vertical axis of the lesser trochanter was （26.80±2.53） mm and its the transverse diameter was（16.09±1.72） mm; The height and the volume of the lesser trochanter was （8.41±1.50） mm and （727.15±165.18） mm3, respectively. The minimum length of the screw used to fix the lesser trochanter of the femur was （46.77±2.70） mm, and the up-dip angle was （16.83±2.06）°, the neck-shaft angle was（131.42±8.03）°, the range of femoral offset was（37.85±7.02）mm. Conclusion It is feasible to accurately identify the anatomical landmarks on the three-dimensional reconstruction of the femur. The measurement data was beneficial to treatment of the elderly patients with intertrochanteric fractures and design of the proximal femoral internal fixation system for fixation of the lesser trochanter.