解剖学报 ›› 2023, Vol. 54 ›› Issue (5): 586-592.doi: 10.16098/j.issn.0529-1356.2023.05.013

• 解剖学 • 上一篇    下一篇

基于股骨颈截面形态调整术中C臂机的透视角度

朱求亮1* 喻向萍2 马骏1 陈匀匀3 林芳3 阮文斌   

  1. 1.安吉县人民医院骨科, 浙江 湖州 313300; 2.安吉县妇幼保健院财务科, 浙江 湖州 313300; 3.安吉县人民医院手术室, 浙江 湖州 313300
  • 收稿日期:2022-03-29 修回日期:2022-05-13 出版日期:2023-10-06 发布日期:2023-12-25
  • 通讯作者: 朱求亮 E-mail:zhuqiuliang666@163.com
  • 基金资助:
    湖州市科技局公益性应用研究项目

Adjustment of X-ray angle intraoperation based on the anatomic shape of femoral neck section 

ZHU Qiu-liang1*  YU Xiang-ping2  MA Jun1  CHEN Yun-yun LIN Fang3 RUAN Wen-bin   

  1. 1.Department of Orthopaedic Surgery, People’s Hospital of Anji, Zhejiang Huzhou 313300, China;  
    2.Finance Section, Anji Maternity and Child Health Care Hospital, Zhejiang Huzhou 313300, China;  
    3.Operating Room, People’s Hospital of Anji, Zhejiang Huzhou 313300, China
  • Received:2022-03-29 Revised:2022-05-13 Online:2023-10-06 Published:2023-12-25
  • Contact: Qiu-Liang ZHU E-mail:zhuqiuliang666@163.com

摘要:

目的 根据股骨颈截面实体解剖特点,探讨完整显影股骨颈解剖结构的术中C形臂X线透视角度。   方法  观察并测量股骨颈截面解剖参数,将组成股骨颈的3个主要曲面(前曲面、后上曲面及后下曲面)分别用铝箔纸贴附,做成股骨颈的曲面透视模型。以股骨颈中点为投照中心点,设定0°~170°之间每间隔10°旋转C形臂,依次3种铝箔纸模型分别进行X线投照,取铝箔纸显影呈最小时的透视角度为该曲面的适宜投照角度。3枚克氏针分别穿出股骨颈前曲面、后上曲面及后下曲面做成股骨颈内固定穿出模型,用传统正、侧位以及实验所获得的3个适宜投照角度共5个角度透视,观察穿出股骨颈克氏针的显影情况。   结果  股骨颈3个主要曲面长度占股骨颈周长的8095%,其前曲面冠状角为18°,后上曲面冠状角为65°,后下曲面冠状角为165°,3个曲面的适宜投照角度分别为20°、70°和170°,在这3个投照角度的影像上,可以清晰地分别观察到穿出股骨颈前曲面、后上曲面及后下曲面的克氏针,而在传统的正、侧位影像上不能发现克氏针完全穿出股骨颈的相应曲面。   结论  术中传统的正、侧位透视不能精确显示股骨颈整体三维结构。增加适宜投照角度20°位、70°位及170°位,分别可以观察股骨颈前曲面、后上曲面及后下曲面的骨折复位质量和内固定对相应骨皮质损伤。 

关键词: 股骨颈, 截面, 内固定, C型臂, 透视, 解剖学, 人 

Abstract:

 Objective  To investigate the appropriate X-ray angle which image can represent total proximal of femur according to the anatomic shape of the femoral neck section.   Methods  The anatomic parameter of the femoral neck section was observed and measured. Found the femoral neck was contained with three main surfaces of anterior surface, posterosuperior surface and posteroinferior surface. A model of surface fluoroscopy has been made by covering aluminum foil papers on the three surfaces of femoral neck. Taking the midpoint of the femoral neck as the fluoroscopy center, the C-arm was rotated at an interval of 10° between 0° and 170°, and the three aluminum foil paper models were taken for X-ray projection respectively. The X-ray angle with the smallest image of aluminum foil paper was taken as the appropriate X-ray angle of the surface.  A penetrating model of the femoral neck internal fixation was made of three Kirschner wires penetrating through the anterior, posterosuperior and posteroinferior surfaces of femoral neck. The images of the penetrating Kirschner wires were observed through the traditional anteroposterior, lateral view and the three appropriate X-ray angle views obtained from the above test.   Results  The length of the three main surfaces accounts for 80.95% of the circumference of the femoral neck. The anterior surface coronal angle was 18°, the posterosuperior surface coronal angle was 65°, and the posteroinferior surface coronal angle was 165°. The Appropriate X-ray angle of the three surfaces were 20°, 70° and 170° respectively. In the images of the three appropriate X-ray angles, the penetrating Kirschner wires of anterior surface, posterosuperior surface and posteroinferior surface of the femoral neck could be clearly observed respectively, while the penetrating Kirschner wire could not be completely found in the traditional anteroposterior and lateral images.   Conclusion  Traditional anteroposterior and lateral fluoroscopy can not accurately display the three-dimensional structure of femoral neck. By increasing the appropriate X-ray angle of 20°, 70° and 170°, the reduction quality and bony violation from internal fixation implants on the anterior surface, posterosuperior surface and posteroinferior surface of the femoral neck could be observed respectively. 
 

Key words:  Femoral neck, Section, Internal fixation, C-ram, Fluoroscopy, Anatomy, Human

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