汉族与蒙古族胫骨近端部分数字化解剖形态的测量与对比

Measurement and comparison of the digital anatomy of the tibia proximal part for the Han and Mongolian nationality

背景:在进行国人膝关节假体设计以及全膝关节置换时,不仅要考虑到国人胫骨近端解剖特点和几何形态上的差异,同时也还应该注意不同种族间的差异性。目的:通过对汉族与蒙古族胫骨近端的C T断层扫描及三维重建测量,对比其在蒙、汉族之间的解剖形态学差异,为全膝关节置换的假体选择提供数据参考。方法:收集于关节外科就诊的患者60例,其中汉族组、蒙古族组各30例,各组均男15例,女15例,年龄(36.00±7.22)岁。16排螺旋CT扫描仪(美国GE公司Lightspeed 16)对其进行螺旋扫描,层厚0.625 mm,扫描图像以DICOM格式导出存盘。再利用Mimics 15.0三维重建软件进行数字化三维重建测量。分别对胫骨平台宽、胫骨平台内侧前后径和外侧前后径进行测量,以观察其在性别、侧别和民族间是否具有差异性。结果与结论:以上各指标值在左、右侧别间差异均无显著性意义(P>0.05)。胫骨平台宽、胫骨平台内侧前后径和胫骨平台外侧前后径在男、女性别间和汉族、蒙古族之间差异均存在显著性意义(P<0.05),具体表现在:(1)胫骨近端的形态学测量参数无论汉族组还是蒙古族组在性别间差异均存在显著性意义,且男性各均值大于女性。(2)部分参数指标在汉族与蒙古族间存在着一定的差异性,提示在施行人工全关节置换时,应根据国人形态特征、性别、民族、地区等差异正确地选择并放置假体。(3)数字化三维重建技术和个体化设计可以针对不同人群选择适合的假体,从而确保患者在全膝关节置换后获得良好的修复效果。

BACKGROUND： In the process of designing knee joint prosthesis and operating total knee arthroplasty for the Chinese people, we should not only take into account the proximal tibial anatomical characteristics and the difference of geometry but also should pay attention to the differences between different races. OBJECTIVE： To compare the anatomical morphological differences between Mongolian and Hart nationality through measuring the CT tomography scanning and three-dimensional reconstruction measurement of tibia proximal part of Han and Mongolian nationality, so as to provide the data references for prosthesis selection used for total knee arthroplasty. METHODS： Totally 60 patients who received the treatment at the Department of Joint Surgery were collected, and divided into Han nationality and Mongolian nationality groups （n=30/group, 15 males and 15 females in each group）. The age was （36.00＋7.22） years old. 16-row helical CT scan （American GE Lightspeed 16） was used for spiral scanning, slice thickness 0.625 mm. Scanning images were exported in DICOM format and saved. Digital three-dimensional reconstruction measurement was conducted using Mimics 15.0 three-dimensional reconstruction software. The tibial plateau width, anteroposterior diameter of the medial tibial plateau and lateral anteroposterior diameter were measured respectively to observe whether there were any differences among sex, sides and nationality. RESULTS AND CONCLUSION： There were no significant differences in the above indicators between left and right sides （P 〉 0.05）. There were significant differences in tibial plateau width, anteroposterior diameter of the medial tibial plateau and lateral anteroposterior diameter between males and females, and Han and Mongolian nationality groups （P 〈 0.05）. Specific performed in： （1） There was significant difference in the morphological measurement parameters of proximal tibia between sex for Han and Mongolian nationality, and the mean value of male was larger compared with that of female. （2） There was certain significant difference in the part of the parameter indicators between Han and Mongolian nationality groups. These results suggest that the prosthesis should be chose and placed correctly according to the differences of morphological characteristics, gender, nationality, region of the Chinese people. （3） Digital three-dimensional reconstruction technology and individualized design can choose suitable prosthesis for different people, so as to ensure a good repair effect in patients after total knee replacement.