股骨髁X测量及性别判别分析

目的：为积累资料的探讨国人股骨髁的性别差异。方法：随机对３３～７６岁１９４例健康人（男１３８，女５６）拍摄膝部正侧位Ｘ线片；在正位片上测量了上髁宽和内、外侧髁宽，在侧位片上测量了内、外侧髁长和高。用ＳＰＳＳ软件计算出５个指数和７个性别判别分析式。结果：所测７项均具有非常显著的性别差异（ｔ＝３．５３～１３．９４，Ｐ〈０．０１），５项指数除髁高指数外，均无显著性性别差异；７个性别判别式的回代判别率在７     

动力髁螺钉治疗股骨远端骨折的应用解剖

目的为临床应用动力髁螺钉治疗股骨远端骨折提供解剖学数据。方法 (1)男女性股骨标本各30根,测量股骨髁宽、内侧髁宽、外侧髁宽、内侧髁前后径、外侧髁前后径、股骨内侧髁倾角、股骨外侧髁倾角等数值。(2)X线摄片30位正常成年志愿者股骨,进行冠状面上角度测量。结果股骨髁宽、内侧髁髁宽、外侧髁髁宽、内侧髁前后径、外侧髁前后径等值均有显著的性别差异(P<0.01),同性别内侧髁倾角明显大于外侧髁倾角(P<0.01)。股骨干与股骨远侧段之间的夹角、股骨干与股骨近侧段之间的夹角、股骨干与膝关节面之间的夹角存在性别差异(P<0.01～P<0.05)。股骨远侧段与股骨近侧段的夹角不存在显著的性别差异(P>0.05)。结论动力髁螺钉手术中应注意股骨髁形态的性别差别和股骨远侧段存在的弯曲,以提高动力髁螺钉治疗股骨远端骨折的手术效果。     

国人股骨髁的测量及性别判别分析

为积累国人资料和探讨股骨髁的性别判别分析 ,对 114副东北出土的股骨 (男 51、女 63)测量了上髁宽、内外侧髁的长宽高 7项 ,经 SPSS软件计算出 5项指数和 6个性别差别式及其差别率。结果 :除内侧髁宽 ,余 6项测量指标均有非常显著的性别差异 ( t=2 .61～ 5.0 8,P<0 .0 1) ;5项指数中除髁宽指数外 ,余均无性别差异 ;6个性别差别式的正确判别率在 67.54%～ 70 .61%间     

掌骨的X线测量及其与身高的性别判别分析

目的：探讨掌骨的侧别与性别差异及性别判别方法，积累有关解剖学资料。方法：随机选择健康汉族大学生，进行双手后前位x线拍片，分别测量各掌骨长与中点宽，同时测量身高，将所得数据用SPSS软件进行统计学分析处理。结果：男性第2、4、5掌骨宽度以及女性第3、4、5掌骨宽度左右手侧差有显著性意义，男女性别差异亦有显著意义；同时应用Fisher法分析得出4个判别式，判别率分别为87．6％和89．8％。结论：所得性别判别式对法医学性别判别应用价值较大，为体质人类学和法医学提供了有关解剖学资料。     

指骨的X线测量及其性别判别关系

目的：对指骨各指节的长度及宽度进行X线测量，为法医学及人类学提供判别率较高的性别判别式。方法：随机选择健康汉族大学生186人(男90人，女96人)，进行双手后前位X线拍片，分别测量各掌骨长与中点宽，将所得数据应用SPSS软件进行统计学分析。结果：男性指骨左右示指近节宽、中指近节宽及环指近节宽侧别差异有显著性意义，女性侧别差异无显著性意义；除小指近节指骨宽外，性别差异均有显著性意义。应用Fisher法提出8个性别逐步判别式，判别率在86．0％-91．9％之间。结论：以上判别式对法医学及人类学的性别鉴定简单实用，具有较高参考价值。     

股骨远端解剖形态性别差异与假体形态设计的关系

目的：通过三维螺旋CT重建正常人膝关节，测量股骨远端相关解剖参数，探讨男女性股骨远端的解剖特点对于关节表面假体形态的不同要求。方法：80侧正常成人膝关节，男性、女性各40侧，年龄18～72岁，行三维螺旋CT扫描，在GE Advantage workstation工作站上进行0．625mm层厚重建，测量股骨经上髁轴线宽度、内外侧髁高度、髁间高度及内外侧滑车前突距离，行模拟截骨后，测量各截骨面高度，比较各测量值性别问的差异。结果：男女性髁间高度、经上髁轴线宽度、外侧髁高度及内侧髁高度均有显著性差异（P〈0．001），男性各值均大于女性。股骨远端横径与纵径的比值亦为男性大于女性（P〈0．001），男性股骨内、外侧滑车前突距离均大于女性，均值差分别为1．2mm和0．7mm，均有显著性差异（P〈0．001）。结论：男女性之间股骨髁形态存在一定差别，股骨远端关节面假体形态的设计应该性别差异化，使假体与截骨面更好的吻合。以提高全膝关节置换术的手术效果。     

股骨下端的测量及Guo区指数分析

本对东北地区成年股骨150套进行了股骨下端八项测量及Guo区指数分析，主要结果为：股骨下端所测各项均值有显的性别差异而无侧别差异。     

股外侧肌腱与股骨外侧髁接触的解剖学观察及其临床意义

目的：探讨髌骨半脱位致髌骨外侧软骨面压力过高的形态学因素。方法：对５０侧膝关节标本股外侧肌腱内面及其与股骨外侧髁的接触进行了解剖学观察。结果：股外侧肌腱内面呈椭圆形或圆形光滑面。其周围有滑膜皱襞附着，其长２．１±０．９（１．０～５．４）ｃｍ，宽１．３±０．４（０．７～２．４）ｃｍ，与髌上囊以皱襞相隔。在屈曲９０°时与股骨外侧髁边缘相接触，接触处为光滑的骨软骨结构约１．０ｃｍ×０．８ｃｍ大小。摸拟髌骨半脱位时，整个股四头肌腱外移，股外侧肌腱内面与股骨外侧髁不能接触。结论：①在正常情况下股外侧肌腱内面与股骨外侧髁存在着接触，这可能是缓解髌骨外侧关节软骨面压力的正常接触；②当髌骨半脱位时，该接触减小或消失，可能是髌骨半脱位时外侧面压力增高的原因之一     

股骨远端微创锁定内固定钢板固定参数的三维数字化测量

背景：有研究表明股骨远端微创锁定内固定钢板治疗股骨远端骨折具有较好的疗效,但其设计参数多为参照西方人种数据,且其产品规格有限。 目的：对成年中国人中远端股骨微创锁定内固定钢板手术相关解剖CT数据进行数字化测量。 方法：选自内蒙古医学院第二附属医院影像科非膝关节疾患的成人CT连续扫描数据15例,利用Mimics 10.01软件进行三维重建,在三维立体图形中测量股骨远端宽;股骨外侧髁前后径;股骨外侧髁基底部宽;股骨外侧髁干角;自股骨大转子下缘5 cm至外上髁每隔5 cm划分为1段,共分为5段,分别测量每段中部股骨内外侧皮质及髓腔横径。 结果与结论：成年中国人中远端股骨微创锁定内固定钢板固定后,股骨远端左右侧宽分别为(84.80±1.27) mm和(84.60± 1.40) mm;股骨外侧髁前后径分别为(67.36±1.41) mm和(66.27±1.42) mm;股骨外侧髁基底部宽分别为(42.53±3.42) mm和(42.98±1.25) mm;股骨外侧髁干角分别为(7.58±0.69)°和(7.66±0.79)°,左右侧别间差异均无显著性意义。 关键词：微创锁定内固定钢板;股骨远端;三维重建;设计参数;数字化骨科 doi:10.3969/j.issn.1673-8225.2012.13.003     

少年举重运动员膝关节形态结构的X线研究

本文对少年举重运动员与不从事专项运动者的左右膝关节正位 X 线片进行了形态学观察。结果表明:举重运动员的股骨下端与胫骨上端内外侧髁肥大突出,骨小梁的压力曲线增粗,排列密集,清晰;膝关节股外侧关节面与胫骨外侧髁上关节面间隙较大;髁间隆起略大;股骨角与胫骨角均在正常值范围内,未出现膝内、外翻现象。上述结果可作为举重运动训练及临床诊断的参考.     

Comparison of medial and lateral posterior femoral condyle articular cartilage wear patterns

Background

While degenerative changes to the articular cartilage of the anterior and distal portions of the femoral condyles have been well studied in the literature, the changes that occur on the posterior femoral condyle are not as clear. The purpose of this study was to assess the difference in articular cartilage thickness between the medial and lateral posterior femoral condyles in knees undergoing unicompartmental knee arthroplasty.

股骨内髁参数对单髁置换中截骨及假体设计的参考意义

BACKGROUND: Knee-parameter measurements play an important role in the designing of the knee prosthesis. Currently, we have more and more research of the total knee replacement, while uni-condylar knee replacement study is few.  OBJECTIVE: To obtain the parameters of the normal femoral condyles and explore its correlation with osteotomy and prosthesis design of the knee joint during uni-condylar knee replacement. METHODS: Normal knee joints of 60 cases (60 knees) were selected. We measured the parameters by using thin-section CT scan and post-processing techniques, including arc diameter of the lowest point of the femoral condyle on the coronal plane, arc diameter of the distal point of the posterior condyle of the femur on the transverse plane, arc diameter of the distal point of the posterior condyle of the femur on the sagittal plane, and arc diameter of the lowest point of the femoral condyle on the sagittal plane, and analyzed the correlation with sex and height.  RESULTS AND CONCLUSION: The diameter of the arc that passes through the lowest point of femoral medial condyle in the coronal plane was (42.685±1.389) mm. The diameter of the arc that passes through the farthest point of posterior of femoral medial condyle in the cross-section was (42.732±1.440) mm. The diameter of the arc that passes through the lowest point of femoral medial condyle on the sagittal plane was (45.473±1.332) mm. The diameter of the arc that passes through the farthest point of posterior of femoral medial condyle on the sagittal plane was (42.587±1.446) mm. The results illustrate that knee condyle related parameters were positively correlated with height. Parameters in males were significantly greater than in females. The diameter of the arc that passes through the lowest point of femoral medial condyle on the sagittal plane was significantly larger than that of the farthest point of femoral posterior medial condyle on the sagittal plane (P < 0.001). There was no significant difference among the diameter of the arc that passes through the lowest point of femoral medial condyle on the coronal plane, the diameter of the arc that passes through the farthest point of posterior of femoral medial condyle on the cross-section and that of the farthest point of femoral posterior medial condyle on the sagittal plane.       

股骨远端解剖数据测量及其与膝关节假体径线的匹配性探讨

目的　将股骨远端解剖结构相关数据与国内常用的膝关节假体参数进行对比,评估假体吻合度,为设计符合解剖结构的假体提供参考。 方法　①选100例无明显骨质缺损的华南地区成人股骨标本 (左51,右49), 拍数字化照片;②校正放大率后测量：机械轴长度、机械轴/解剖轴夹角、髁横径、髁间截骨面横径、外髁前后径、内髁前后径;③测量Zimmer NexGen LPS、Stryker Scrorpio NRG Knee-Flexed、United-U1、威高 GKPS假体的髁内外径宽、假体前髁高度及后髁高度。 结果　(1)股骨远端横径为(7.60±0.60) cm,股骨远端外侧髁高度为(5.90±0.76) cm,内侧髁高度为(5.73±0.74) cm,其间无明显相关性;(2) 4品牌假体的截骨长度均可适应股骨远端骨结构,但前髁截骨高度与4种品牌假体前髁高度对比,在设定容差范围内的涵盖率为24%~55%,股骨后髁高度与假体的后髁高度对比,涵盖率仅14%~21%。 结论　股骨远端解剖形态数据分布较为弥散,在关节置换过程中需个体化处理。假体径线与华南地区国人股骨远端形态存在一定差异。     

Anterior-posterior stability of the knee by an MR image subtraction method

The purpose of our study was to test the hypothesis that when a shear force was applied posteriorly to the loaded knee in vivo, there would be no relative motion between the tibia and the medial femoral condyle. Siemens 7 Tesla high-resolution MRI machine was used to scan eight healthy male volunteers with the knee at 15° of flexion. Two scans were obtained: the first with a compressive force of 660 N along the tibial long axis and a second with the compressive force and a posterior shear force of 36 N applied to the tibia. Solid models were created of the femur, tibia, and menisci for both loading conditions. The tibial models were superimposed enabling the displacements of the femur and menisci to be determined, relative to a fixed tibia. On average, the lateral femoral condyle displaced anteriorly by 0.66 mm but the medial femoral condyle displaced posteriorly by 0.36 mm. This indicated an axial rotation with a center between the lateral and medial condyles, but closer to the medial. The menisci displaced with the femoral condyles, but there was no indication that the medial meniscus was contributing to the pivoting action. This study supported the concept of medial anterior-posterior stability under weight-bearing conditions, but with structures other than the medial meniscus providing the stability. This study has application to the treatment of knee injuries and to knee arthroplasty design.     

The potential effect of anatomic relationship between the femur and the tibia on medial meniscus tears

Background

The anatomic and the kinematical relationships between the femur and the tibia have been previously examined in both normal and diseased knees. However, less attention has been directed to the effect of these relationships on the meniscal diseases. Therefore, we aimed to investigate the impact of femorotibial incongruence on both lateral and medial meniscal tears.

Materials and methods

A total of 100 images obtained from MRI of 100 patients (39 males and 61 females) were included in the study. Diameters of the medial and the lateral femoral condyles, thicknesses of the menisci, and diameters of the medial and the lateral tibial articular surfaces were measured.

Results

The medial meniscus tear was detected in 40 (40 %) patients. However, no lateral meniscus tear was found. Significant relationships were found between the diameters of the posterior medial femoral condyle and the medial tibial superior articular surface and between the diameters of the posterior lateral femoral condyle and the lateral tibial superior articular surface. The mean values for the diameter of the medial condyle of the femur, the lateral condyle of the femur, the medial superior articular surface of the tibia, and the lateral superior articular surface of the tibia were found to be significantly higher in cases with meniscus tear compared to cases without meniscus tear. However, no significant difference was present regarding the thicknesses of the medial and the lateral menisci. A positive relationship between the diameter of the posterior medial femoral condyle and the tibial medial superior articular surface was found in cases with (n = 40) (r ² = 0.208, p = 0.003) and without tear (n = 60) (r ² = 0.182, p = 0.001). In addition, a significant positive relationship was found between the diameter of the posterior medial femoral condyle and the medial tibial superior articular surface in cases with and without tear.

Conclusion

The impact of femorotibial incongruence on the medial meniscus tear is important for the understanding of the lesions.     

人体下肢长骨负重关节软骨下松质骨显微硬度分布特征的研究

目的:探讨人体下肢长骨负重关节软骨下松质骨显微硬度的分布特征。方法:选取3具年龄大于40岁的新鲜冰冻尸体标本,取出所有标本的右侧股骨和胫骨,分别于股骨头、股骨内髁、股骨外髁、胫骨内髁、胫骨外髁、胫骨远端距负重区关节软骨面1 cm处,垂直于下肢机械轴切下3 mm厚松质骨样本。使用维氏显微硬度测量系统测量骨组织显微硬度。比...     

双侧股骨内外侧髁解剖学

目的测量股骨髁的某些形态参数,确定股骨髁在形态方面是否存在左右差异。方法收集郑州大学解剖学教研室的股骨111个(左侧64个和右侧47个),用游标卡尺测量相关数据。结果股骨的平均双髁宽度为左侧(7.79±0.56)cm,右侧(7.66±0.40)cm(P0.05)。内侧髁长度相对值是左侧(6.09±0.53)cm和右侧(5.97±0.41)cm(P0.05);外侧髁长度为左侧(6.06±0.43)cm和右侧(6.00±0.41)cm(P0.05);髁间宽度为左侧(1.92±0.24)cm和右侧(1.83±0.16)cm(P0.05);髁间深度为左侧(2.94±0.25)cm和右侧(2.90±0.25)cm(P0.05)。提示双侧的股骨髁各项数据在统计学上没有明显的差别。结论双侧股骨髁的一致性可能是设计全膝关节假体的理论基础,健侧膝关节可用于术前制作患侧模板。     

CT-based morphological analysis of the posterior femoral condyle in patients with trochlear dysplasia

Background

The anterior part of the distal femur in trochlear dysplasia has been well investigated; however, to date, posterior morphological characteristics have not been well studied. This study aimed to evaluate whether the posterior femoral condyle in patients with trochlear dysplasia differs from those without trochlear dysplasia.