胫骨高位截骨术相关角度的X线片测量及3D重建测量差异分析

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摘要目的本研究旨在验证胫骨高位截骨术下肢全长X线片测量与3D重建测量间是否存在差异。方法选取我院骨科2016年6月至2018年7月拟行胫骨近端高位截骨术的22例合并胫骨内翻的内侧单间室骨关节炎患者，共计23膝，分别通过下肢全长X线片及3D重建测量胫骨近端内侧角、股骨远端外侧角及后倾角，比较两种方法测得结果的差异。结果通过X线片测得胫骨近端内侧角(medial proximal tibia angle，MPTA)为(84.5±3.9)°，与3D重建后测量的MPTA为(82.0±3.1)°差异有统计学意义；通过X线片测得股骨远端外侧角(lateral distal femoral angle，LDFA)为(87.7±2.7)°，与3D重建后测量的LDFA(88.0±2.3)°差异无统计学意义；通过X线测得胫骨平台后倾角(posterior slope angle，PSA)为(11.4±3.9)°，与3D重建后测量的PSA(12.5±3.5)°差异无统计学意义。结论在预行胫骨高位截骨术的患者中，正常的解剖角度测量，单纯通过X线片测量即可提供相对可靠的结果，但是对于胫骨近端内侧角，尤其是该角度可能影响手术选择、手术预案及术后疗效等方面，3D重建后的测量更为准确。

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关键词 ： 3D建模, 3D测量, X线片测量, 胫骨高位截骨术

Abstract：Objective To verify whether there is a difference between the X-ray measurement of lower limbs and the 3D reconstruction measurement.Methods 22 patients with tibial varus deformity and knee medialcompartmental osteoarthritisadmittedfrom June 2016 to July 2018，which included a total of 23 knee.Weobtained the difference betweent X-ray and 3d reconstruction measurement of MPTA，LDFA and PSA respectively.Results There was statistical difference between X-ray measured MPTA (84.5±3.9)° and 3d reconstruction measurement of MPTA (82.0±3.1)°.There was no statistical difference between Xray measured LDFA ( 87.7±2.7)° and 3d reconstruction measurement of LDFA (88.0±2.3)°.There was no statistical difference between X-ray measured PSA(11.4±3.9)° and 3d reconstruction measurement of PSA (12.5±3.5)°.Conclusion For patients need HTO，X-ray measurement can provide relatively reliable results in normal anatomical angle measurement.However，for abnormalanatomical angle，especially the angle that may affect surgical selection，surgical plan and postoperative efficacy，the 3D reconstruction measurement is more accurate.

Key words： 3D modeling 3D measurements X-ray measurements high tibial osteotomy

通讯作者: 曹光磊

作者简介: 吴厦(1988－ )，男，医师，首都医科大学宣武医院骨科，102218。

引用本文:

吴厦 1，2，王君玲 3，曹光磊 1*，安帅 1，杨光中 1，王研农 1. 胫骨高位截骨术相关角度的X线片测量及3D重建测量差异分析[J]. 实用骨科杂志, 2019, 25(5): 419-422.
Wu Sha 1，2，Wang Junlin 3，Cao Guanglei 1，et al. Difference Analysis between X-ray Measurement and 3D Reconstruction Measurement in the Relative Angles of High Tibial Osteotomy. sygkzz, 2019, 25(5): 419-422.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2019/V25/I5/419

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