X线评估后交叉韧带胫骨隧道安全范围的初步分析-外科学(骨外)专业论文.docxVIP

万方数据 万方数据 目 录 中文摘要 ·············································································1 英文摘要 ·············································································2 英文缩写 ·············································································4 研究论文 X 线评估后交叉韧带胫骨隧道安全范围的初步分析 前言 ·············································································5 材料与方法 ····································································6 结果 ·············································································7 附图 ·············································································8 附表 ·············································································9 讨论 ·············································································11 结论 ·············································································13 参考文献 ·······································································14 综述 后交叉韧带重建手术的研究进展 ········································17 致谢 ···················································································25 个人简历 ·············································································26 PAGE 10万方数据 PAGE 10 万方数据 中 文 摘 要 X 线评估后交叉韧带胫骨隧道安全范围的初步分析 摘 要 目的：通过膝关节侧位片模拟 Transtibial 技术中胫骨隧道与胫骨平台 平面的夹角，初步探讨 Transtibial 技术中一个可行的安全角度范围 方法： 1 选择2014年1月1日至2015年3月1日之间和河北医科大学第三医院 骨科标准膝关节正侧位 X 线198 例，其中男性91例， 女性107例， 平 均年龄34.5±8.61岁； 2 使用影像归档和通信(PACS)系统确定后叉韧带胫骨止点中心， 作 双平行线形模拟胫骨隧道，下切线与胫骨后缘保持2mm距离，取下切线与 胫骨平台夹角为隧道与胫骨平台最大安全角度，取上切线与胫骨前方交点 为胫骨隧道入口上缘位置，测量胫骨结节与此点距离。 3 两个骨科主治医师分别对每个夹角及距离进行测量。比较男、女夹 角度数值及胫骨隧道入口上缘距胫骨平台距离。 结果：1 男，女及总的测量值均符合正态分布。2 胫骨最大安全角度 平均值为64.2±5.3°，男女及总的例数中有95%位于52°~75°之间，性别之 间无差异。隧道上缘距胫骨结节距离总平均值为8.34±0.82cm，男女之间 具有统计学意义，总体有95%位于6.90-9.67cm范围内，其中男性有95%处 于7.03-9.74cm，女性则是6.86-9.67cm。男性则有95%大于7.42cm，女性为 7.04cm，总体为7.20cm，男女之间有统计学意义。 结论： 1 通过膝关节X线侧位测量Transtibial技术中胫骨隧道与胫骨平台夹 角所计算出的安全角度范围为52°~75°。 2 当隧道上缘距胫骨平台影像距离男性小于7.42cm，女性小于7.04 cm时建立胫骨隧道，可认为是安全的。 关键词：后交叉韧带重建,胫骨隧道, X 线,杀伤角，影像归档及通信系 统 英 英