摘要
目的探讨屈膝15°髌股关节轴位X线片在髌骨排列异常诊断中的作用及意义。方法选择无髌股关节症状和体征的志愿者15名(30膝)作为对照组(A组)。将43例(68膝)有膝前痛,经临床检查诊断为髌骨排列异常的患者分为三组:外侧不稳组(B组),19例33膝;内侧不稳组(C组),8例14膝;多向不稳组(D组),16例21膝。对全部病膝及正常对照膝拍摄屈膝15°和30°髌股关节轴位X线片,测量沟角(SA)、适合角(CA)、外侧髌股角(LPFA)、髌股指数(PFR)和髌骨倾斜角(PTA),并进行对照分析。根据CA测量结果将D组中CA小于-10°的患者归为D1组(内→外不稳组),CA大于16°的患者归为D2组(外→内不稳组)。结果(1)B组、C组屈膝15°和30°的SA值差异有显著性(P<0.01);(2)A组屈膝15°和30°的CA值差异无显著性(P>0.05),其他各组差异均有显著性(P<0.01);(3)A组、D1组屈膝15°和30°的LPFA值差异有显著性(P<0.05,P<0.01);(4)C组、D2组屈膝15°和30°的PFR值差异有显著性(P<0.01);(5)A组、C组屈膝15°和30°的PTA值差异有显著性(P<0.01);(6)B组、C组、D1组、D2组屈膝15°的CA值和A组比较差异有显著性(P<0.01),B组屈膝30°的CA值和A组比较差异有显著性(P<0.01)。结论应用屈膝15°髌股关节轴位X线片测量CA来诊断髌骨排列异常比屈膝30°更敏感。
Objective To discuss the role of skyline view taken in 15° kne e flexion in diagnosis of patellofemoral joint malalignment. Methods All research population were separated into four groups. Group A(normal) consisted of fifteen (30 knees) volunteers who had no symptoms or signs related to the knee. Group B (lateral instability) consisted of nineteen (33 knees) patients. Group C (media l instability) consisted of eight (14 knees) patients. Group D (multidirectional instability) consisted of sixteen (21 knees) patients. Skyline radiography of p atellofemoral joints were taken with the knee in 15° and 30° flexion, then fiv e parameters (including SA, CA, LPFA, PFR and PTA) were measured and analysed. Group D was separated into two subgroups according to CA. Group D1(medial→later al instability) consisted of the patients whose CA were less than-10 degrees. G roup D2 (lateral→medial instability) consisted of the patients whose CA were gr eater than 16 degrees. Results 1) There were significant differences between the SA with the knee in 15° and 30° flexion in group B and group C (P< 0.01). 2) There was no significant difference between the CA with the knee in 15° and 30 ° flexion in group A (P >0.05), but there were significant differences in the o ther groups (P< 0.01). 3) There was significant difference between the LPFA with the knee in 15° and 30° flexion in group A and group D1 (P< 0.05, P< 0.01). 4 ) There were significant differences between the PFR with the knee in 15° and 30° flexion in group C and D2 (P< 0.01). 5) There were significant differences between the PTA with the knees in 15° and 30° in group A and C. 6) There were significant differences between the CA in group B, C, D1, D2 and group A with th e knee in 15° flexion (P< 0.01). There was significant difference between the C A in group B and group A with the knee in 30° flexion (P< 0.01). Conclusion CA is more diagnostic and accurate when the knee is in 15° rather than 30° flexio n.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2003年第4期226-229,共4页
Chinese Journal of Orthopaedics
