摘要
目的研究股骨远端旋转对线参考轴线与胫骨机械轴的关系，确定最为可靠参考轴线，并探讨其优越性。方法对30例下肢尸体标本分别在膝关节伸直位、屈膝90°进行数码照相，照片经计算机处理后，分别测量股骨机械轴、临床髁上轴的垂线、外髁髁上轴的垂线、Whiteside线与胫骨机械轴的夹角，并将其相比较进行统计学分析。结果临床髁上轴的垂线、外髁髁上轴的垂线、Whiteside线、股骨机械轴相对于胫骨机械轴分别为内翻0．6°、内翻3．9°、外翻0．2°、内翻3．0°。临床髁上轴、外髁髁上轴、Whiteside线在伸膝时与屈膝时比较分别为外翻2．3°、内翻0．9°、外翻3．1°。股骨机械轴与胫骨机械轴的夹角大于临床髁上轴垂线、Whiteside线与胫骨机械轴的夹角，其差异具有统计学意义（P〈0．05）；而与外髁髁上轴垂线和胫骨机械轴的夹角相比较，差异无统计学意义（P〉0．05）。结论外髁髁上轴是较临床髁上轴、Whiteside线更为可靠的股骨假体旋转对线参考标志，术中参考外髁髁上轴行股骨后髁切骨时可获得相对良好的胫股关节、髌股关节运动轨迹。
Objectives To investigate the relationships among rotational alignment reference axes of distal femur and tibial mechanical axis, and determine the safest rotational alignment reference axis. Methods Digital photos were taken of 30 cadaveric lower extremities with knee in extension and flexion at 90°, angles were measured among tibial mechanical axis and a line perpendicular to clinical epicondylar axis, a line perpendicular to surgical epicondylar axis, Whiteside＇s line and femoral mechanical axis. Statistical analysis of relationships among those axes were performed. Results The angles among the tibial mechanical axis and a line perpendicular to the clinical epicondylar axis, a line perpendicular to the surgical epicondylar axis, Whiteside＇s line and femoral mechanical axis were 0.6° varus, 3.9°varus, 0. 2°valgus and 3.0°varus respectively. The angle between the femoral mechanical axis and the tibial mechanical axis was significantly larger than the angles among the tibial mechanical axis and a line perpendicular to the clinical epicondylar axis, the Whiteside＇s line （P 〈 0.05 ）. There was no significant difference compared with the angle between a line perpendicular to the surgical epicondylar axis and the tibial mechanical axis. Angles of the clinical epicondylar axis, the surgical epicondylar axis and the Whiteside＇s line between knee extension and flexion were 2.3° valgus, 0.9° varus and 3. 1° valgus respectively. Conclusion The surgical epicondylar axis rather than the clinical epicondylar axis or the Whiteside＇s line is the safest femoral rotational alignment reference axis intraoperatively.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2008年第14期1085-1087,共3页
Chinese Journal of Surgery
关键词
关节成形术
置换
膝
股骨
胫骨
旋转
实验研究
Arthroplasty, replacement, knee
Femur
Tibia
Rotation
Experimental study
