Schiessel Andreas, Zweymüller Karl
Orthopädisches Krankenhaus Wien, Wielemansgasse 28, 1180 Vienna, Austria.
Skeletal Radiol. 2004 Mar;33(3):142-9. doi: 10.1007/s00256-003-0728-8. Epub 2004 Jan 29.
Plain antero-posterior and lateral radiographs of the femur often show radiolucent lines, which may reflect the canal of a nutrient artery. In patients who have undergone total hip replacement these radiolucent lines must be differentiated from fractures caused by bursting of the shaft during the procedure.
In a retrospective radiological study 129 extremities of 95 patients with cementless primary hip prostheses were examined for radiolucent lines. Pre- and postoperative antero-posterior and lateral radiographs were analyzed.
In 34 of 129 extremities (26.4%) radiolucent lines compatible with a nutrient artery canal were detected, 14 of which (10.9% overall) were seen on lateral radiographs. In 11 of 129 extremities (8.5%) a nutrient artery canal was detected only on the antero-posterior views, while in 9 of 129 extremities (7.0%) it was well defined in both projections. One patient (0.8%) presented with a fracture postoperatively, which was radiologically distinct from a nutrient artery canal. The distance between the tip of the greater trochanter and the proximal end of the nutrient artery canal was 170+/-25 mm; the canal length was 27+/-9 mm.
Nutrient artery canals are often seen radiologically on pre- and postoperative radiographs down to the mid-shaft level and should be routinely recorded.
股骨前后位和侧位平片常显示透亮线，这可能反映了滋养动脉的管腔。在接受全髋关节置换术的患者中，这些透亮线必须与手术过程中股骨干爆裂所致骨折相鉴别。
在一项回顾性放射学研究中，对95例接受初次非骨水泥型髋关节假体置换患者的129个肢体进行了透亮线检查。分析了术前和术后的前后位及侧位X线片。
在129个肢体中的34个（26.4%）检测到与滋养动脉管腔相符的透亮线，其中14个（总体为10.9%）在侧位X线片上可见。在129个肢体中的11个（8.5%）仅在前后位片上检测到滋养动脉管腔，而在129个肢体中的9个（7.0%）在两个投照位上均显示清晰。1例患者（0.8%）术后出现骨折，在放射学上与滋养动脉管腔不同。大转子尖与滋养动脉管腔近端之间的距离为170±25mm；管腔长度为27±9mm。
在术前和术后X线片上，直至股骨干中部水平，常可在放射学上见到滋养动脉管腔，应常规记录。
