Sen Ramesh Kumar, Tripathy Sujit Kumar, Kumar Raj, Kumar Amit, Dhatt Sarvdeep, Dhillon Mandeep Singh, Nagi O N, Gulati Madhu
Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Orthop Surg (Hong Kong). 2010 Aug;18(2):189-94. doi: 10.1177/230949901001800211.
To compare anatomic, radiographic, and computed tomographic (CT) measurements of the proximal femur in an Indian population.
26 left and 24 right dried cadaveric femurs were obtained. Each femur was divided into segments at 10 cross-sectional levels from proximal to distal. At each level, anteroposterior (AP), lateral, 45-degree internal oblique, and 45-degree external oblique diameters of the medullary canal were measured using radiography and CT. To minimise magnification, the femur was placed over the film/board. The neck shaft angle, femoral head offset, neck length, and femoral head diameter were also measured. For anatomic measurements, the cross-sections of the medullary canal at levels 3 to 10 were measured using a calliper. Anatomic measurements were compared with radiographic and CT measurements, and the distortion calculated. Correlation between the 3 modalities was calculated using the Pearson correlation coefficient. Accuracy index of the 2 diagnostic modalities was measured, based on the differences between anatomic and radiographic/CT measurements. Lower accuracy indices indicated higher accuracy.
On AP radiographs of all femurs, the mean femoral head diameter was 45 mm, the mean neck shaft angle was 132 degrees, the mean femoral head offset was 42 mm, and the mean neck length was 63 mm. With regard to medullary canal diameters, the radiographic and CT measurements were smaller than anatomic measurements at proximal levels, but similar at distal levels. Variations between femurs and between the 4 diameters at the same level were greater at proximal levels.
Combined use of radiography and CT is recommended for preoperative assessment of implant size, particularly in uncemented arthroplasty where an optimal fit is essential for biological fixation.
比较印度人群近端股骨的解剖学、影像学及计算机断层扫描（CT）测量结果。
获取26例左侧和24例右侧干燥尸体股骨。将每根股骨从近端到远端分为10个横截面水平段。在每个水平，使用X线摄影和CT测量髓腔的前后径（AP）、侧径、45度内斜径和45度外斜径。为使放大率最小化，将股骨置于胶片/板上。还测量了颈干角、股骨头偏移、颈长和股骨头直径。对于解剖学测量，使用卡尺测量3至10级水平髓腔的横截面。将解剖学测量结果与影像学和CT测量结果进行比较，并计算变形量。使用Pearson相关系数计算这三种方式之间的相关性。根据解剖学与影像学/CT测量结果之间的差异，测量两种诊断方式的准确性指数。较低的准确性指数表明准确性较高。
在所有股骨的前后位X线片上，股骨头平均直径为45mm，颈干角平均为132度，股骨头偏移平均为42mm，颈长平均为63mm。关于髓腔直径，近端水平的影像学和CT测量值小于解剖学测量值，但远端水平相似。近端水平股骨之间以及同一水平的四个直径之间的差异更大。
建议联合使用X线摄影和CT进行术前植入物尺寸评估，尤其是在非骨水泥型关节置换术中，最佳匹配对于生物固定至关重要。
