桡骨小头三维解剖研究及其对假体设计的影响

目的 通过数字化三维重建正常中国人桡骨小头大体形态,测量解剖参数,为选择、设计假体提供解剖学依据. 方法对45例正常中国人进行单侧肘关节CT扫描,利用Mimics 10.0软件进行数字化三维重建来测量桡骨小头的解剖形态,并与国外相关资料进行比较. 结果桡骨小头的形状和大小有明显的个体差异,各形态参数接近正态分布,桡骨小头冠状面最大直径平均(22.34±2.46)mm,髓内冠状面直径平均(9.04±1.50)mm,桡骨小头矢状面最大直径平均(22.63±2.50)mm,髓内矢状面直径平均(9.34±1.51)mm,颈于角平均166.80°±2.20°,头颈长平均(18.71±2.44)mm.身高与桡骨小头直径成正相关(P<0.05). 结论测量所得桡骨小头解剖资料与欧美人种的桡骨小头解剖存在差异,应对进口假体适当改进,以提高疗效.三维数字化重建对解剖学测量和定制假体的意义重大.

Three-dimensional geometry of the radial head and its prosthetic design

Objective To obtain anatomic parameters of the normal Chinese radial head through digital three-dimensional reconstruction so as to provide anatomical evidence for design of radial head pros-thesis. Methods Unilateral elbow joints of 45 normal Chinese were scanned by CT. Three-dimensional reconstruction of the radial head was performed using Mimics 10.0 software on the basis of the CT data. The parameters of the radial head were measured by Mimics 10.0 software and compared with the data reported in the existing overseas literature. Results The radial head had obvious individual diversities in shape and size. All morphologic parameters of the radial head approximated a normal distribution. The anteroposterior diameter of the radial head: (22.34±2.46) mm, the anteruposterior canal diameter: (9.04±1.50) mm, the mediolateral diameter of the radial head: (22.63±2.50) mm, the mediolateral canal diameter: (9.34±1.51) mm, the neck shaft angle: 166.80°±2.20°, the length of the radial head and neck: (18.71±2.44) mm. The diameter of the radial head had a strong correlation with the body height. Conclusions Since the anatomical parameters of the Chinese radial head are different from those of other races, it is important to modify the overseas prostheses to enhance the effectiveness of treatment. Three-dimensional digital recon-struction plays a great significance rule in the anatomical measurement for design of a customized prosthesis.