股骨头力学承载三柱结构的划分及测量

Demarcation and Measurement Method for the Three Pillars of the Femoral Head

目的:构建以生物力学理论为基础的股骨头三柱结构的划分方法及依据。方法:收集拍摄双髋关节正位X线片的正常股骨头志愿者50例(100髋),在双髋关节X线片图像上过股骨头圆心做一水平线(股骨头最大横径),以水平线与主压力骨小梁为外侧缘、内侧缘的交点为标准,将股骨头分为三柱,分别测算外侧柱、中间柱及内侧柱的均值,并根据均值测算结果计算得到比例。结果:共纳入100髋拍摄双髋正位片志愿者,测定结果为:外侧柱所占比例为0.31,中间柱所占比例为0.39,内侧柱所占比例为0.30,三者比例为3.1∶3.9∶3.0。结论:为方便临床应用,按照3∶4∶3的比例在股骨头最大橫径上划分股骨头的外侧柱、中间柱及内侧柱三柱,该方法使得股骨头三柱结构的划分有据可循。

Objective:To establish basic principles for three-pillar structure demarcation bones based on biomechanical theory.Methods:Fifty healthy volunteers(100 hips) were enrolled.Frontal X-ray pictures of the bilateral hip joints were taken.A horizontal line was made(the maximum transverse diameter of the femoral head) through the center of the femoral head on the X-ray image of both hip joints.The intersection of the horizontal line and the lateral and medial margins of the main pressure bone trabecula was taken as the standard so that the femoral head was divided into three columns.The mean values of the lateral column, the middle column and the medial column were calculated respectively, and the proportion was calculated according to the calculated results of the mean values.Results:A total of 100 volunteers to whom frontal X-ray pictures of the bilateral hip joints were taken were included in the study.The results showed that the proportion of the outer column was 0.31,the proportion of the middle column was 0.39,and the proportion of the inner column was 0.30.The proportion of the three columns was 3.1∶3.9∶3.0.Conclusion:For clinical convenience, the three pillars can be demarcated at 3∶4∶3 along the maximum transverse diameter of the femur head.The study results provide an exact basis for the demarcation of the three pillars.