Department of Orthopaedic Surgery, Linkou Branch, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City, Taiwan.
Department of Imaging Diagnosis, Taipei Branch, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City, Taiwan.
Orthop Surg. 2020 Aug;12(4):1270-1276. doi: 10.1111/os.12708. Epub 2020 Jun 16.
A retrospective study was conducted using magnetic resonance image (MRI) and a full-length standing scanogram (FLSS) to measure the quadriceps angle (Q-angle) while avoiding soft tissue interference.
Two steps were retrospectively carried out in two case series. The first step involved using MRI to define the standardized patellar center (PC) and the tibial tubercle (TT) on the frontal plane of the MRI in one group of 60 consecutive patients (from July 2016 to December 2016, 29 men and 31 women, average of 46 years). The next step was transferring the location of the standardized PC and the TT from the MRI to the FLSS in another group of 100 consecutive patients (from April 2009 to March 2014, 50 men and 50 women, average of 36 years). The pelvis and intact femur, knee, and tibia were used to determine the Q-angle on the FLSS.
The standardized PC was positioned 42% from the lateral end of femur trans-epicondylar line. The TT was 2 cm distal to the tibial articular surface and 37% from the lateral end of tibial width. The average Q-angle was 9.5° in 100 patients (8.8° in 50 men and 10.1° in 50 women, P = 0.02). The average femoral length was 42.9 cm in 100 patients (44.7 cm in 50 men and 41.1 cm in 50 women, P < 0.001). Women and men had similar pelvic width (27.9 vs 27.8 cm, P = 0.89).
Using the FLSS may help to accurately determine the Q-angle. Men and women have similar pelvic width. A larger Q-angle in women may be mainly due to the shorter femur.
本研究回顾性地使用磁共振成像（MRI）和全长站立位侧位片（FLSS）测量了股四头肌角（Q 角），同时避免了软组织干扰。
在两个病例系列中分别进行了两步回顾性研究。第一步，在一组 60 例连续患者（2016 年 7 月至 12 月，男 29 例，女 31 例，平均年龄 46 岁）的 MRI 矢状面图像上，使用 MRI 定义标准化髌骨中心（PC）和胫骨结节（TT）。下一步，将标准化 PC 和 TT 的位置从 MRI 转移到另一组 100 例连续患者（2009 年 4 月至 2014 年 3 月，男 50 例，女 50 例，平均年龄 36 岁）的 FLSS 上。FLSS 上使用骨盆和完整的股骨、膝和胫骨来确定 Q 角。
标准化 PC 位于股骨髁外上连线的 42%处。TT 位于胫骨关节面下方 2cm 处，距胫骨宽度的外侧端 37%处。100 例患者的平均 Q 角为 9.5°（50 例男性为 8.8°，50 例女性为 10.1°，P = 0.02）。100 例患者的平均股骨长度为 42.9cm（50 例男性为 44.7cm，50 例女性为 41.1cm，P < 0.001）。男性和女性的骨盆宽度相似（27.9cm 比 27.8cm，P = 0.89）。
使用 FLSS 可能有助于准确确定 Q 角。男性和女性的骨盆宽度相似。女性 Q 角较大可能主要是由于股骨较短。
