Garron E, Jouve J-L, Tardieu C, Panuel M, Dutour O, Bollini G
UMRC 6578, Unité d'anthropologie, Adaptabilité Biologique et Culturelle, CNRS-Université de la Méditerranée, Faculté de Médecine Timone, 13385 Marseille Cedex 5.
Rev Chir Orthop Reparatrice Appar Mot. 2003 Sep;89(5):407-12.
We performed a biometric analysis of the femoral trochlea in the fetus and compared our findings with those observed in adults in order to search for correlations with other biometric parameters of the femur.
Twenty-two fetuses (44 knees) conserved in formol and free of known orthopedic disease were studied. Fetal age ranged from 26 to 40 weeks. After anatomic dissection, digitalized images were used to obtain angle measurements with a dedicated software. Measurements made on the distal epiphyseal view were: anteroposterior dimension of the condyles, medial and lateral protrusion of the trochlear borders, difference in condyle height, length of the trochleal borders, alpha angle of the trochlear groove, trochlear slope. Measurements made on the AP femoral view were: femoral anteversion, length of the femoral neck, neck-shaft angle. Spearman's test was used to search for correlations. Results were compared with measurements obtained under the same conditions in a series of 32 adult knees published by Wanner.
The trochlear alpha angle was 148 degrees (coefficient of variation 4%). The angle was greater than 150 degrees for 18 trochleae. The lateral border of the trochela was higher than the medial border in 37 of the 44 knees. There was no correlation with age and gender. Femoral anteversion was 27.01 degrees, with a high coefficient of variation (46%), and no correlation with the trochlear alpha angle. Comparison with measurements made on the adult knees revealed no significant difference.
This is the first report of statistically significant biometric data of the fetal trochlea. The morphology of the lower femur observed during the third trimester of fetal live is the same as observed in adults. Morphological changes in the proximal femur occurring during growth do not appear to modify the morphology of the distal femur. The asymmetrical ingression of the patella into the trochlea, characteristic of modern man, is considered to result from bipedalism. Our study would suggest that the anatomic characteristics of the trochlea could have been integrated into the genoma during the course of evolution. This would be in favor of a genetic origin of trochlear dysplasia.
我们对胎儿的股骨滑车进行了生物测量分析，并将我们的研究结果与成年人的进行比较，以寻找与股骨其他生物测量参数的相关性。
研究了22例保存在甲醛中且无已知骨科疾病的胎儿（44个膝关节）。胎儿年龄在26至40周之间。解剖后，使用数字化图像通过专用软件获取角度测量值。在远端骨骺视图上进行的测量包括：髁的前后径、滑车边界的内侧和外侧突出、髁高度差异、滑车边界长度、滑车沟的α角、滑车斜率。在股骨前后位视图上进行的测量包括：股骨前倾、股骨颈长度、颈干角。使用Spearman检验寻找相关性。将结果与Wanner发表的一系列32个成人膝关节在相同条件下获得的测量值进行比较。
滑车α角为148度（变异系数4%）。18个滑车的角度大于150度。44个膝关节中有37个滑车的外侧边界高于内侧边界。与年龄和性别无相关性。股骨前倾为27.01度，变异系数较高（46%），与滑车α角无相关性。与成人膝关节测量值的比较显示无显著差异。
这是关于胎儿滑车统计学显著生物测量数据的首次报告。胎儿期晚期观察到的股骨下端形态与成人观察到的相同。生长过程中股骨近端发生的形态变化似乎并未改变股骨远端的形态。现代人特有的髌骨不对称进入滑车被认为是两足行走的结果。我们的研究表明，滑车的解剖特征可能在进化过程中已整合到基因组中。这将支持滑车发育异常的遗传起源。
