股骨大转子形态及临床意义研究进展

Research Progress on Morphology and Clinical Significance of Greater Trochanter of Femur

股骨大转子与髋关节关系密切,是股骨髓内针、髋关节置换等髋部手术中重要的解剖标志。根据大转子后上壁骨质在侧位像上的形态变异将其分为前倾型、后倾型、中央型、扁平型和双峰型;而在颅顶俯瞰视角下根据后上壁骨质是否阻挡梨状窝及阻挡的程度也可将大转子进行分型。此外大转子"裸区"的发现也为股骨顺行髓内针入针点提供了新思路。大转子的形态变异对临床髋部手术的快速定位造成困扰,因此为缩短髋部手术时间以及减少术中并发症发生,充分了解大转子的形态变异类型至关重要。

As an important anatomic landmark in hip surgery of femoral intramedullary nail and total hip arthroplasty,greater trochanter is closely related to the hip joint. The greater trochanter is categorized into anterior leaning,posterior leaning,centred,flat and double apex type according to its morphological variation of the posterior superior wall in the lateral image,and it can also be graded according to the relative location between the greater trochanter and piriform fossa from a cranial view. In addition the finding of ″bald spot″ also gives a potential portal for antegrade femoral nailing. The anatomic variation of morphology of greater trochanter causes difficulty in intraoperative localization,therefore thorough understanding of the variation of morphology of greater trochanter is very important for decreasing operation time and intraoperative complication of hip surgery.