股骨颈中轴线尾端在股骨外侧定位点的放射学评价

背景:股骨转子间骨折股骨颈中轴线尾端在股骨近端外侧定位点的确定是准确置入内固定物首要的最关键步骤。目的:对股骨颈中轴线尾端在股骨近端外侧定位点进行放射学印证。方法:在80根成人股骨标本上画出股骨颈前表面的顺股骨颈方向的中央线及股骨近端外侧面纵向中央线的交点。用细钢丝在股骨颈中部紧贴骨质环绕一周并将小钢珠分别粘放在定位点处(A)及在股骨近端外侧面纵向中央线上斜坡顶点以下1.0cm(B),2.0cm(C),3.0cm处(D),然后顺股骨颈方向分别拍X射线片,观察小钢珠显影点在铁丝圈的位置。测量小钢珠显影点中心与标记出的铁丝圈的中心点的间距,并记录显影点位于中心处的标本数量。结果与结论:小钢珠在定位点(A),斜坡顶点以下1.0cm处(B),2.0cm处(C),3.0cm处(D)显影点在位于铁丝圈中心的比例分别为85%,18.75%,81.25%,35%,B、D处的中心百分率与A点比较差异有显著性意义(P<0.05)。提示股骨颈前表面的顺股骨颈方向的中央线及股骨近端外侧面纵向中央线的交点可作为股骨颈中轴线尾端在股骨近端外侧定位点。

Radiological evaluation of the anchor point of femoral neck axial line tail on the femoral lateral wall

BACKGROUND:Determining the anchor point of femoral neck axial line tail on the femoral lateral wall is the most primary and critical steps for the placement of internal fixator during the treatment of femoral intertrochanteric fractures.OBJECTIVE:To radiological confirm the anchor point of femoral neck axial line tail on the femoral lateral wall.METHODS:The central line on the anterior surface of the femoral neck along femoral neck and the vertical central line on femoral proximal lateral wall were drawn on 80 adult femoral specimens.The intersection point of the above two central line was assumed as the anchor point of femoral neck axial line tail on the proximal femoral lateral wall.The thin steel wire was placed around the middle of femoral neck closely and a small steel ball was struck on the anchor point(A) and the on the point which located at 1.0 cm(B),2.0 cm(C) and 3.0 cm(D) below the slope top point on the longitudinal center line on lateral surface of proximate femur,then the X-ray images were took along the femoral neck axis,and the location of the small steel ball imaging on the wire circle was observed.The distance between the center point of the small steel ball and the wire circle was measured,and the amount of the imaging point in the center.RESULTS AND CONCLUSION:The proportion of the small steel ball imaging that located on the point A,B,C and D on the center of the wire circle was 85%,18.75%,81.25% and 35%,and there was significant difference of the proportion between point B and D and point A(P < 0.05).The intersection point of the central line on the anterior surface of the femoral neck and the vertical central line on femoral proximal lateral wall can be regarded as the anchor point of femoral neck axis tail on femoral lateral wall.