股骨近端髓腔形态与PFNA匹配性研究
发布时间：2019-06-06 04:11
【摘要】：目的:股骨粗隆间骨折已经广泛采用PFNA治疗,PFNA与股骨髓腔解剖形态的匹配性也一直存在争议。本研究通过医学图像处理软件对成人股骨干CT进行处理,测量股骨近端髓腔横截面不同方向上的直径,并对多个样本的测量数据进行统计。观察股骨近端髓腔直径的变化有无统计学意义,并找出最小直径的位置变化规律。根据测量所得数据,分析PFNA与髓腔的匹配性,进一步完善PFNA的设计与临床应用。方法:采集行股骨全长CT扫描患者共60例,筛选其中符合研究条件患者50例,其中男性25例,女性25例,年龄均在50-90岁之间。将其股骨CT扫描数据用医学图像处理软件MIMICS10.01处理,测量股骨近端的解剖参数,包括大粗隆顶点至小粗隆水平距离,大粗隆顶点至股骨髁距离。小粗隆水平至股骨峡部分别取若干水平截面,每平面间隔1cm,在每个截面上分别对8个方向上的直径进行测量。根据所测量数据,统计其分布规律,并对男女两组的测量值运用统计学软件以检验其差异性。计算其比值以总结其是否具有临床意义。根据所测得的解剖参数与PFNA参数相比较,衡量其匹配性。结果:1.大粗隆顶点至小粗隆平面距离:男性组a值变化范围为4.80-6.40cm;女性组中a值变化范围4.70-5.50cm。男性组平均值为5.456cm,女性组平均值4.976cm,两组之间存在统计学差异。2.髓腔最小直径:男女性在髓腔最小直径上无明显差异性分布,50例样本平均值为10.718mm。3.股骨髓腔最小直径出现位置与大粗隆顶点距离:男性平均值17.424cm,女性平均值16.886cm,男性大于女性。4.K值范围38.88%-46.92%。两组之间无明显统计学差异。5.最小髓腔直径:男性组髓腔最小直径范围:8.19-14.18mm,女性组髓腔最小直径范围:8.99-12.61mm,两组之间髓腔最小直径无统计学差异,总体平均值为10.72mm。结论:1.老年股骨髓腔最小直径出现的平面位置与股骨干长度具有一定比例关系,此比例值的分布相对集中。男性出现最小直径的位置要比女性低。2.绝大多数(82%)样本髓腔的最小直径均出现于D0方向,也就是股骨的冠状径方向。证明临床中下肢中立位x片上的髓腔内径基本反映出了髓腔的最小值。术前运用下肢中立位x片来评估髓腔直径及选取主钉规格是有意义的。3,临床上存在一定数量髓腔最小直径≤9mm的病人(分布比例为10%),考虑PFNA均要通过其最小直径所在平面,因此直径更小的主钉是有需求的。
[Abstract]:Objective: PFNA has been widely used in the treatment of intertrochanter fracture of femur, and the matching of PFNA and anatomical morphology of bone marrow cavity has been controversial. In this study, the CT of adult thigh shaft was processed by medical image processing software, and the diameters of the transverse section of the proximal pulp cavity of the femurs were measured, and the measured data of several samples were statistically analyzed. The changes of the diameter of the proximal medullary cavity were observed and the position of the minimum diameter was found out. According to the measured data, the matching between PFNA and pulp cavity was analyzed, and the design and clinical application of PFNA were further improved. Methods: a total of 60 patients with full-length CT scan of femurs were collected. 50 of them were selected, including 25 males and 25 females, all of whom were between 50 and 90 years of age. The CT scanning data of femurs were processed with medical image processing software MIMICS10.01 to measure the anatomical parameters of proximal femurs, including the horizontal distance from the apex of large trochanter to small trochanter and the distance from the apex of large trochanter to the condyle of femur. A number of horizontal sections were taken from the small trochanter level to the isthmus of the femurs, with an interval of 1 cm per plane, and the diameters in eight directions were measured on each section. According to the measured data, the distribution law was counted, and the statistical software was used to test the difference between the two groups. The ratio was calculated to summarize its clinical significance. According to the measured anatomical parameters and PFNA parameters, the matching property was measured. Result: 1. The distance from the peak of large trochanter to the plane of small trochanter: the range of a value in male group was 4.80 鈮，
本文编号：2494057
[Abstract]:Objective: PFNA has been widely used in the treatment of intertrochanter fracture of femur, and the matching of PFNA and anatomical morphology of bone marrow cavity has been controversial. In this study, the CT of adult thigh shaft was processed by medical image processing software, and the diameters of the transverse section of the proximal pulp cavity of the femurs were measured, and the measured data of several samples were statistically analyzed. The changes of the diameter of the proximal medullary cavity were observed and the position of the minimum diameter was found out. According to the measured data, the matching between PFNA and pulp cavity was analyzed, and the design and clinical application of PFNA were further improved. Methods: a total of 60 patients with full-length CT scan of femurs were collected. 50 of them were selected, including 25 males and 25 females, all of whom were between 50 and 90 years of age. The CT scanning data of femurs were processed with medical image processing software MIMICS10.01 to measure the anatomical parameters of proximal femurs, including the horizontal distance from the apex of large trochanter to small trochanter and the distance from the apex of large trochanter to the condyle of femur. A number of horizontal sections were taken from the small trochanter level to the isthmus of the femurs, with an interval of 1 cm per plane, and the diameters in eight directions were measured on each section. According to the measured data, the distribution law was counted, and the statistical software was used to test the difference between the two groups. The ratio was calculated to summarize its clinical significance. According to the measured anatomical parameters and PFNA parameters, the matching property was measured. Result: 1. The distance from the peak of large trochanter to the plane of small trochanter: the range of a value in male group was 4.80 鈮，
本文编号：2494057
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