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轴向旋转对胫骨近端内侧角测量的影响
Hits: 680   Download times: 293   Received:March 09, 2023    
作者Author单位UnitE-Mail
杜瑞勇 DU Rui-yong 北京王府中西医结合医院骨科, 北京 102209 Department of Orthopaedic, Beijing Royal Integrative Medicine Hospital, Beijing 102209, China  
吴厦 WU Sha 北京美德瑞骨科医生集团, 北京 102200
清华大学附属北京清华长庚医院关节病中心, 北京 102218
Beijing Medera Medical Group, Beijing 102200, China
Center of Joint Disease, Beijing Tsinghua Changgung Hospital, Beijing 102218, China
 
马琦 MA Qi 北京美德瑞骨科医生集团, 北京 102200
清华大学附属北京清华长庚医院关节病中心, 北京 102218
Beijing Medera Medical Group, Beijing 102200, China
Center of Joint Disease, Beijing Tsinghua Changgung Hospital, Beijing 102218, China
 
刘璞 LIU Pu 北京王府中西医结合医院骨科, 北京 102209
北京美德瑞骨科医生集团, 北京 102200
Department of Orthopaedic, Beijing Royal Integrative Medicine Hospital, Beijing 102209, China
Beijing Medera Medical Group, Beijing 102200, China
 
景峰 JING Feng 北京美德瑞骨科医生集团, 北京 102200
焦作市中站区人民医院骨科, 河南 焦作 454191
Beijing Medera Medical Group, Beijing 102200, China
Department of Orthopaedic, Jiaozuo Zhongzhan People's Hospital, Henan Jiaozuo 454191, China
 
蔡谞 CAI Xu 北京美德瑞骨科医生集团, 北京 102200
清华大学附属北京清华长庚医院关节病中心, 北京 102218
Beijing Medera Medical Group, Beijing 102200, China
Center of Joint Disease, Beijing Tsinghua Changgung Hospital, Beijing 102218, China
caixu_changgeng@163.com 
期刊信息:《中国骨伤》2023年36卷,第12期,第1165-1168页
DOI:10.12200/j.issn.1003-0034.2023.12.011


目的:通过在负重位X线片上测量并比较双下肢不同轴向旋转角度(中立位、内旋30°位、外旋30°位)下的胫骨近端内侧角(medial proximal tibial angle,MPTA),探讨胫骨不同轴向旋转位置MPTA测量值变化及其意义。

方法:自2018年1月至2018年12月选取40例膝骨关节炎(knee osteoarthritis,KOA)患者,共计80侧,其中男12例,女28例;年龄29~73(59.6±12.7)岁。分别拍摄胫骨中立位、内旋30°位和外旋30°位双下肢负重全长X线片,测量其MPTA并对其结果进行组内和组间比较。

结果:左下肢胫骨中立位、内旋30°位和外旋30°位MPTA分别为(86.08±2.48)°、(88.62±2.94)°和(83.47±3.10)°,右下肢MPTA分别为(86.87±1.97)°、(89.02±2.39)°和(83.80±2.77)°,同旋转角度组内MPTA测量值比较,差异无统计学意义(P>0.05);同侧肢体组间MPTA比较,差异有统计学意义(P<0.05)。在内旋30°位时,左、右下肢MPTA较胫骨中立位增加(2.54±1.74)°、(2.15±1.78)°;在外旋30°位时,左、右下肢MPTA较胫骨中立位减少(2.61±2.03)°、(3.07±1.75)°。

结论:拍摄双下肢负重位全长X线片时,若胫骨存在轴向内旋或者外旋,测得的MPTA会较中立位产生增大或者减少的变化,使临床工作中需要基于MPTA准确测量而进行的手术操作可能出现一定程度的偏差。但这种偏差导致的临床手术效果受影响的程度尚需验证。此外,受限于样本总量及测量分组数量,MPTA的偏差与胫骨轴向旋转之间是否存在线性关系有待进一步研究。
[关键词]:胫骨近端内侧角  MPTA  胫骨  轴向旋转
 
Influence of axial rotation on measurement of medial proximal tibial angle
Abstract:

Objective To measure and compare medial proximal tibial angle (MPTA) of lower limbs under different axial rotation angles(neutral position,30° internal rotation,30° external rotation) on the load position radiographs,and explore changes and significance of MPTA measured within and between groups of tibia at different axial rotation positions.

Methods From January 2018 to December 2018,40 patients with knee osteoarthritis (KOA) were selected,with a total of 80 limbs,including 12 males and 28 females,aged from 29 to 73 years old with an average of (59.6±12.7) years old. Full length radiographs of the lower limbs were taken on neutral tibia position,30° internal rotation and 30° external rotation,respectively. MPTA was measured and the results were compared between groups and within groups.

Results MPTA measured on the left lower extremity of neutral tibia,30° internal rotation and 30° external rotation were (86.08±2.48) °,(88.62±2.94) ° and (83.47±3.10) °,respectively. MPTA measured on the right lower limb were (86.87±1.97) °,(89.02±2.39) ° and (83.80±2.77) °,respectively,and there were no significant difference in MPTA measured between rotation angle group (P>0.05). While there were statistical difference in MPTA on the same limb between groups (P<0.05). On 30° internal rotation,MPTA of left and right lower limbs increased by (2.54±1.74) ° and (2.15±1.78) ° compared with tibia neutral position. On 30° external rotation,MPTA of left and right lower limbs decreased (2.61±2.03) ° and (3.07±1.75) ° compared with tibial neutral position.

Conclusion When a full-length X-ray film is taken on the weight-bearing position of both lower limbs,if there is axial rotation or external rotation of tibia,MPTA will increase or decrease compared with neutral position,which may cause a certain degree of deviation in clinical operation based on the accurate measurement of MPTA. However,the extent to which this bias affects the clinical operation effect remains to be verified. In addition,limited by the total number of samples and the number of measurement groups,whether there is a linear relationship between MPTA deviation and tibial axial rotation needs to be further studied.
KEYWORDS:Medial proximal tibial angle  MPTA  Tibia  Axial rotation
 
引用本文,请按以下格式著录参考文献:
中文格式:杜瑞勇,吴厦,马琦,刘璞,景峰,蔡谞.轴向旋转对胫骨近端内侧角测量的影响[J].中国骨伤,2023,36(12):1165~1168
英文格式:DU Rui-yong,WU Sha,MA Qi,LIU Pu,JING Feng,CAI Xu.Influence of axial rotation on measurement of medial proximal tibial angle[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(12):1165~1168
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