肉眼直观区别股骨颈扭转角与前倾角

Distinguish differentiation between femora neck torsion angle and femora neck anteversion in description and clinic value by eyes

目的探讨肉眼直观下描述股骨颈扭转角及前倾角的区别,并分析其差异的临床意义。方法在股骨冠状面平面,分别从6点钟、12点钟、1∶30点钟、3点钟和4∶30点钟位置观察干燥完整的股骨标本(60根),在照片上分别确定股骨头颈轴线、股骨冠状面、股骨颈截面最长径及股骨上段冠状面,画图描述股骨颈扭转角与前倾角,分析这两个角度的区别。结果股骨颈前倾角是股骨头颈轴线与股骨冠状面的夹角,是线与面的关系,角尖朝内,在6点钟、12点钟、1∶30点钟、3点钟和4∶30点钟位均可观察到;股骨颈扭转角是股骨颈椭圆截面最长径线构成的面与股骨(上段)冠状面的夹角,是面与面的关系,角尖朝后,仅在12点钟、1∶30点钟、3点钟位可以观察到。1∶30钟位是显示股骨颈扭转角和前倾角区别的最佳位置。结论股骨颈前倾角和扭转角是共同基于股骨冠状面,分别与股骨头颈轴线、股骨颈截面最长径线构成的面,组成的两个不同角度参数。非立体观察是混淆股骨颈扭转角与前倾角的重要原因。前倾角决定内固定螺钉及股骨假体的方向,扭转角对内固定螺钉进钉点及股骨髓腔开口位置有参考价值。

Objective To identify the difference between femora neck torsion angle（ FNTA） and femora neck anteversion（ FNA） in macroscopical description and to analyze its clinic value. Methods Sixty dried femurs were observed at 12,6,3,4： 30 and 1： 30 o＇clock positions in the coronal plane. The axis of the femoral neck,femoral coronal place,proximal femur coronal place and the surface which constituted the longest diameter on the section of femoral neck in the photograph were determined. The difference between FNTA and FNA was described,and analyzed. Results The position of 1： 30 o＇clock was the best position to observe FNTA and FNA simultaneously. FNTA was the surface which constituted the longest diameter on the section of femoral neck and the femur conoral plane,or the proximal femur conoral plane,and was seen at 12 o＇clock,3 o＇clock,and 1： 30. The apex of the angle was backwards. The FNA was the angle between the axis of the femoral neck and the femur coronal plane,and was seen at 6,12,3,1： 30 and 4： 30 o＇clock. The apex of the angle was inwards. Conclusion FNTA and FNA are two completely different anatomic angle parameters of the proximal femur at the same femoral coronal place and the surface which constitutes the longest diameter on the section of femoral neck or the axis of femoral neck. The FNA determines the direction of the internal fixation screw and the femoral prosthesis,and FNTA determines the entry point of the internal fixation screw and mark the inlet of the femoral medullary cavity in prosthetic replacement.