髌骨解剖学参数测量及髌骨骨折导向器的设计研究

Measurement of patella anatomical parameters and study of patella fracture guide device

目的:利用三维软件测量正常髌骨的解剖学形态,为髌骨骨折手术治疗及改进导向器提供解剖学依据。方法:2016年8月至2018年12月共采集458例膝关节DICOM格式数据,排除不符合纳入标准样本,共纳入94例正常髌骨,其中男49例,女45例。纳入样本的DICOM数据均导入Mimics中重建和测量。按性别分组测量髌骨极点高度、髌骨高度、髌骨宽度、髌骨嵴厚、内1/3厚度及外1/3厚度。按髌骨张力带固定原则设计克氏针导向器。结果:髌骨极点高度、髌骨高度、髌骨宽度、髌骨嵴厚、内1/3厚及外1/3厚男性依次为(46.87±2.32)、(31.42±1.83)、(44.83±2.42)、(21.86±1.87)、(19.62±1.76)、(15.38±1.89)mm;女性依次为(42.38±1.98)、(28.06±2.01)、(39.12±2.03)、(19.47±1.93)、(17.31±1.93)、(14.01±1.72) mm。各参数间比较均有统计学差异,男性髌骨大于女性髌骨,外1/3厚度小于内1/3厚度。成功设计一个适用于髌骨张力带的导向器装置。结论:髌骨解剖学参数测量为髌骨骨折治疗及导向器改进提供解剖学依据,髌骨骨折张力带导向器使髌骨骨折固定更为精准、简便。

Objective:To measure the morphology of normal patella with the three-dimensional software,so as to provide anatomical parameters for surgical treatment of patella fracture and improving guide devices. Methods:A total of 458 cases of knee DICOM format data from August 2016 to December 2018 were collected. After excluding substandard samples,94 cases of normal patella were selected,including 49 cases of male and 45 cases of female. All the DICOM data were put into Mimics software for reconstruction and measurement,and patellar pole height,patellar height,patellar width,patellar thickness,inner 1/3 thickness and outer 1/3 thickness of different gender were measured in groups. Results:Patellar pole height,patellar height,patellar width,patellar thickness,inner 1/3 thickness and outer 1/3 thickness in the male group were(46.87±2.32),(31.42±1.83),(44.83±2.42),(21.86±1.87),(19.62±1.76)and(15.38±1.89) mm,respectively;in the female group were(42.38±1.98),(28.06±2.01),(39.12±2.03),(19.47±1.93),(17.31±1.93),(14.01±1.72) mm,respectively,with statistically significant differences among those parameters. Male patella was larger than female patella,and inner 1/3 thickness was less than outer 1/3 thickness. A guide device suitable to patella tension band was successfully designed. Conclusion:The measurement of patella anatomical parameters provides anatomical basis for treating patella fracture and guide device of patella tension band makes fixation of patella fracture more accurate and convenient.