胫骨平台相对于股骨远端宽度的X线片测量及其对胫骨平台宽度复位的指导意义

Measuring width of normal tibial plateau relative to distal femur on anteroposterior radiographs of the knee and evaluating its guiding significance for reduction of tibial plateau width

目的 评估胫骨平台相对于股骨远端宽度的X线片测量参数在胫骨平台骨折术中胫骨平台宽度复位时的指导意义。方法 纳入自2019-12—2021-06完成的148例(208膝)正常成人标准中立位膝关节X线片,测量股骨远端内外上髁宽度(Distal femoral width,DFW)、股骨关节面宽度(Femoral articular width,FAW)、胫骨平台关节面宽度(Tibial articular width,TAW),并计算TAW/DFW比值和TAW/FAW比值,按性别和左右侧别分组进行比较。结果 男性TAW/DFW比值为0.92±0.03,女性TAW/DFW比值为0.92±0.01,差异无统计学意义(t=-1.86,P=0.07)。男性TAW/FAW比值为1.04±0.02,女性TAW/FAW比值为1.04±0.01,差异无统计学意义(t=0.90,P=0.37)。左膝TAW/DFW比值为0.92±0.02,右膝TAW/DFW比值为0.92±0.02,差异无统计学意义(t=0.11,P=0.92)。左膝TAW/FAW比值为1.04±0.02,右膝TAW/FAW比值为1.04±0.02,差异无统计学意义(t=0.37,P=0.71)。结论 胫骨平台关节面宽度与股骨远端内外上髁宽度、股骨关节面宽度的比值相对恒定,胫骨平台骨折术中可以利用同侧股骨远端或健侧膝关节参数指导胫骨平台宽度复位。

Objective To evaluate the guiding significance of X-ray measurement parameters of tibial plateau width relative to distal femur width in the reduction of tibial plateau width during tibial plateau fracture operation.Methods The true neutral position anteroposterior radiographs of the knee of 148 normal adult patients(208 knees)from December 2019 to June 2021 were included.The distal femoral width(DFW),femoral articular width(FAW),tibial articular width(TAW)was measured.TAW/DFW ratio and TAW/FAW ratio were calculated and compared between gender and bilateral groups.Results The male and female TAW/DFW ratios were 0.92±0.03 and 0.92±0.01,respectively.There was no significant difference in TAW/DFW ratio between the two groups(t=-1.86,P=0.07).The ratio of TAW/FAW was 1.04±0.02 in male and 1.04±0.01 in female.There was no significant difference in TAW/FAW ratio between the two groups(t=0.90,P=0.37).The left knee TAW/DFW ratio was 0.92±0.02,and the right knee TAW/DFW ratio was 0.92±0.02.There was no significant difference between the two groups(t=0.11,P=0.92).The left knee TAW/FAW ratio was 1.04±0.02,and the right knee TAW/FAW ratio was 1.04±0.02.There was no significant difference between the two groups(t=0.37,P=0.71).Conclusion The ratio of the TAW/DFW and the TAW/FAW is relatively constant.The parameters of ipsilateral distal femur or contralateral knee can be used to guide the reduction of tibial plateau width during the tibial plateau fracture operations.