蒙古族人群股骨近端解剖参数X线测量

X-ray measurement of proximal femur anatomical parameters in Mongolian population

目的测量蒙古族人群股骨近端形态参数,为假体设计、改进及术前选择提供参考。方法随机抽取内蒙古自治区三所三级医院331例蒙古族人群的股骨X线片资料,其中男性152例,女性179例。利用华海PACS系统测量股骨头直径、股骨头偏心距、股骨颈干角、小转子中点层面髓腔内径(T0)、小转子中点上20 mm层面髓腔内径(T+20)、小转子中点下20 mm层面髓腔内径(T-20)、峡部髓腔内径,计算股骨髓腔开放指数(canal flare index,CFI)、干骺端髓腔开放指数(metaphyseal canal flare index,MCFI)。利用SPSS25.0分析各解剖参数不同性别间的差异及与年龄的相关性,并比较蒙古族人群股骨近端参数与国内外地区间的差异。结果性别间比较,MCFI均值女性偏大,颈干角、CFI性别间差异无统计学意义,其余参数则男性偏大;T-20及峡部层面髓腔内径与年龄正相关,CFI、MCFI与年龄负相关,其余参数与年龄无相关性;蒙古族人群股骨近端解剖参数与国内外人群均存在一定差异,与南方人群比较,蒙古族人群股骨头直径、股骨头偏心距、T0、T+20、T-20及峡部层面髓腔内径较大,颈干角、CFI及MCFI偏小。结论蒙古族人群相较南方人群拥有更大的股骨头直径、股骨头偏心距、更大的股骨近端髓腔内径、更小的颈干角及CFI、MCFI,假体选择及设计应考虑不同地区、民族间的差异。

Objective To measure the morphological parameters of the proximal femur in Mongolian population and to provide reference for prosthesis design,improvement and preoperative prosthesis selection.Methods A total of 331 mongolian patients who received femur radiographs in the three tertiary hospitals were randomly selected,including 152 males,and 179 females.Huahai PACS system was used to measure femoral head diameter(FHD),femoral offset(FO),femoral neck shaft Angle(FNSA),medullary transverse diameter at the lesser trochanter(T0),Medullary transverse diameter at the 20 mm above lesser trochanter(T+20),medullary transverse diameter at the 20 mm below lesser trochanter(T-20),medullary transverse diameter of isthmus,canal flare index(CFI)and metaphyseal canal flare index(MCFI).SPSS25.0 was used to analyze the gender differences of these parameters and their correlation with age,and the differences between the femoral parameters of the Mongolian population and domestic and foreign regions were mainly compared.Results(1)The MCFI was larger in females,and there were no significant differences in FNSA and CFI between genders,while the other result of parameters were larger in males.(2)The inner diameter of the medullary cavity at T-20 level and isthmus level was positively correlated with age,CFI and MCFI were negatively correlated with age,and the other parameters were not correlated with age.(3)The anatomical parameters of proximal femur in Mongolian population were different from those in different regions at home and abroad.Compared with the southern population in China,the FHD,FO,the inner diameter of the medullary cavity at T0 level,T+20 level,T-20 level and isthmus level were larger in Mongolian population,while the FNSA,CFI and MCFI were smaller.Conclusions Compared with the southern population,the Mongolian population had larger FHD,FO,wider inner diameter of the proximal femoral medulla cavity,smaller FNSA,CFI and MCFI.Preoperative selection and design of prostheses should take into account the differences between different regions and nationalities.