中国人群距骨形态学指标的三维CT测量及其临床意义

目的：采用三维测量方法测量并分析中国人群距骨的形态学指标，提供精确的距骨形态学数据，为设计距骨假体提供参考。方法：参与本研究的志愿者包括男性40人和女性40人，排除4人，最终纳入76人，其中男性39人，女性37人。对距骨形态正常的所有受试者的踝关节进行CT扫描，CT数据经Mimics软件重建为三维模型。对受试者距骨长、宽、高和体积，内踝关节面长、宽和弧度，外踝关节面长、宽和高，滑车前、中和后宽在内的13项形态学指标进行测量，其中9项指标采用Mimics软件测量，4项指标采用Magics软件测量。结果：本组受试者所有测量指标均呈正态分布，左右侧距骨形态学指标比较差异均无统计学意义（P>0.05）。男性受试者距骨长、宽和高分别为（60.85±2.82）、（42.96±2.59）和（33.76±1.73）mm，女性受试者距骨长、宽和高分别为（54.41±2.49）、（39.76±1.78）和（29.72±1.20）mm。男性受试者大部分距骨测量指标均明显大于女性（P<0.05），但女性受试者内踝关节面弧度明显大于男性（P<0.05）。男性和女性受试者外踝关节面弧度和滑车后宽比较差异均无统计学意义（P>0.05）。结论：CT测量法测量距骨形态学指标更便捷，测量误差小，可重复性高，且左右侧距骨一致性高，在设计距骨假体时，健侧距骨的形态学参数可作为重要参考。

Measurement of morphological indexes of talus of Chinese population with three-dimensional CT and its significance

Objective: To measure and anlyze the morphological indexes of talus of the Chinese population with three-dimensional measurement method and to provide the accurate data of morphological parameters of talus, and to pvovide basis for designing the talar prostheses. Methods: Forty male and 40 female volunteers applied for this study and 4 of them were excluded. At last, 76 volunteers of 39 males and 37 females were included. The ankle joints of 76 subjects were scanned by CT and the CT images were reconstructed to three-dimensional model with Mimics software.A total of 13 indexes were measured including talar length, breadth, height, and volume, length, breadth, and radian of medial and lateral malleolus articular surfaces, anterior, middle, and posterior breadth of trochlea; among 13 indexes, 9 indexes were measured through Mimics software,and the other 4 indexes were measured through Magics software. Results: All the indexes of the subjects were normally distributed. There were no significant differences in the morphological indexes between left and right talus in either males or females (P>0.05). The talar length, breadth, and height in the males were (60.85±2.82), (42.96±2.59), and (33.76±1.73) mm, respectively, and in the females they were (54.41±2.49), (39.76±1.78), and (29.72±1.20) mm, respectively. Most of the indexes were larger in the males than the females (P<0.05), whereas radian of medial malleolus articular surface was larger in the females than the males (P<0.05).The radian of lateral malleolus articular surface and the posterior breadth of trochlea of the males and the females had no significant differences (P>0.05). Conclusion: CT measurement method to measure the morphological indexes of talus is more convenient and fast,its measurement error is small,and its erpeatability is high.Left and right sides of talus show strong degree of symmetry, thus the morphological indexes of the contralateral talus can be adopted as a reference for designing talus prosthesis.