中国蒙古族正常人胫骨近端截骨面数字化形态学特征

Anatomical characters of the proximal tibial osteotomy in healthy Mongolia populations

背景:中国蒙古族人胫骨近端截骨面与国外及国内其他民族是否存在差异尚不清楚。目的:通过对蒙古族人胫骨近端截骨面各线性参数测量,分析中国北方地区蒙古族人胫骨近端截骨面解剖形态学特点。方法:CT薄层扫描38例健康蒙古族人志愿者双膝关节,扫描膝关节线上下各20 cm;原始Dicom数据导入电脑。应用Mimics软件,重建膝关节三维模型,隐藏股骨和髌骨。STL格式的胫骨三维模型图像导入3-Matic软件,显示出胫骨的正内侧面,以内侧胫骨平台最低点为基点,在内侧胫骨平台下方6 mm处,保持胫骨7°后倾角模拟全髋关节置换截骨,测量胫骨近端截骨面参数。结果与结论:①测量参数数据:健康蒙古族人志愿者38例胫骨左右侧径(79.99±3.70)mm(左),(80.25±4.01)mm(右);胫骨前后径(52.27±3.07)mm(左),(51.75±2.40)mm(右);胫骨内侧前后径(55.40±2.00)(左),(56.67±2.47)mm(右);胫骨外侧前后径(49.84±2.78)mm(左),49.58±2.80)mm(右);②测量参数差异:蒙古族人左右侧胫骨近端截骨面各线性参数差异无显著性意义(P>0.05);胫骨近端截骨面内侧前后径大于外侧前后径(P>0.05);男性胫骨近端截骨面各线性参数大于女性(P<0.05);蒙古族人胫骨近端截骨面与部分国内外测量结果比较,各线性参数与国外及中国其他民族和地区存在一定差异;③结果证实,东西方种族间胫骨平台截骨面解剖形态学存在明显差异;中国人不同民族及地域,胫骨平台几何学参数同样可能存在差异,未来有必要应用数字骨科技术,对不同地域不同民族进行大样本数据调查和分析。

BACKGROUND： Whether the proximal tibial osteotomy in Mongolia populations has difference with other populations at home and abroad remains unclear.OBJECTIVE： To analyze the anatomical characters of the proximal tibial osteotomy in Mongolia populations in the northern region of China by measuring the relevant linear parameters.METHODS： Thirty-eight healthy Mongolia populations were selected, and their bilateral knee joints were scanned by CT.The original data were exported in DICOM format. Mimics software was used to reconstruct the knee three-dimensional model. The tibial data stored in STL format were imported into 3-matic software, showing the medial surface of the tibia,and 6 mm below the medial tibial plateau maintaining 7° posterior slop was subjected to total hip arthroplasty osteotomy.Subsequently, the relevant parameters were measured.RESULTS AND CONCLUSION： （1） The left tibia transverse diameter was （79.99±3.70） mm, and the right was （80.25±4.01） mm. The left anteroposterior diameter was （52.27±3.07） mm, and the right was （51.75±2.40） mm. The anteroposterior diameter of medial tibia was （55.40±2.00） mm （left）, and （56.67±2.47） mm （right）; the lateral was （49.84±2.78） mm （left）, and （49.58±2.80） mm （right）. （2） In Mongolian populations, the linear parameters showed no significant differences between two sides of the proximal tibial osteotomy （P 〉 0.05）. The anteroposterior diameter of medial tibia was longer than that of lateral one （P 〉 0.05）. The linear parameters of the proximal tibial osteotomy in male were significantly larger than those in female （P 〈 0.05）. There were differences in the linear parameters of the proximal tibial osteotomy between Mongolian populations and other populations. （3）These results indicate that there are significant differences in the anatomical morphology of the tibial plateau between western and eastern countries.Besides, the geometric parameters of the tibial plateau may be different in different ethnic groups and regions. It is necessary to use the digital orthopedic technique to investigate and analyze the large sample data of different ethnic groups in different regions.