成人股骨中下段的解剖学与扁弧形长针的设计应用

目的:通过对成人股骨远端解剖学参数测量及股骨骨髓腔观测,为扁弧形长针的设计及治疗股骨远端骨折提供形态学基础.方法:选用成人干燥股骨60根,平均分为2组,一组测量股骨长度、内外侧髁、内外上髁等有关数据,另一组测量股骨的密质厚度、髓腔内径及髓腔狭窄区、最远端断面皮质骨侧缘切线与中轴线所形成的夹角,并对测量结果进行统计分析.结果:股骨内侧髁宽度为(47.41±3.44)mm;股骨外侧髁宽度为(33.77±4.79)mm;股骨髁干角96.32°±2.30°;远端松质骨的长度为(50.00±7.90)mm;股骨干长度为(382±8.00)mm.成人股骨髓腔形态复杂,近远端呈漏斗状,而中间非松质骨部呈类柱体,中上段1/3部位最为狭窄,远端呈冠状面宽,而非松质骨部呈矢状面宽,且股骨髓腔具有一向前弧度.结论:股骨远端解剖学参数和股骨髓腔形态特点为扁弧形长针的设计研制和临床应用提供了解剖学依据;扁弧形长针其形态结构特点与髓腔顺应性好,可有效抗分离移位、抗旋转,操作简单,成本低廉,是治疗股骨远端骨折的有效内固定器械之一.

Anatomical study of distal two-thirds of femur in adult and the design of long flat arc needle

Objective: To measure the anatomical parameters of distal part of adult femur and to observe the femoral bone marrow cavity, to provide further morphological basis for design the long curved needle to treat the distal femoral fractures. Methods: 60 adult dry femurs were divided equally into two groups. One group was used to measure the femoral length and parameters about the lateral and medial condyles. The other group was applied to measure the thickness of femoral compact bone, inner diameter of bone marrow cavity, angles between the median axis and tangent lines of margin of distal cortical bone and narrow region of bone marrow cavity. All data were analyzed statistically. Results: The width of medial and lateral femoral condyles was 47.41±3.44mm and 33.77±4.79mm respectively;the femoral condyle shaft angle was 96.3°±22.30°. The length of distal spongy bone and shaft was 50.00±7.90mm and 382±8.00mm. The femoral marrow cavity displayed as funnel shape near the distal terminal and barrel shape in the middle part among the non-spongy bone. The marrow cavity within the upper 1/3 part was narrowest, whereas broad at coronal or sagittal planes was within the distal terminal and non-spongy bone respecitvely. The femoral marrow cavity exhibited a forward curvature. Conclusion: The anatomical parameters of distal 2/3 femur and morphological characteristics of bone marrow provide the basis for designing, developing and applicating clinically of the long curved needle. The long flat arc needle is one of the effective internal fixation devices for treating the distal femur fractures due to its capability to adapt adult femoral marrow cavity and refrain from displacement and revolution, and its simple operation and low cost.