双侧股胫腿旋转的个体内差异：105 例健康受试者的 CT 研究。

Intra-individual variance of bilateral femoro-tibial leg rotation: a CT study of 105 healthy subjects.

机构信息

Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martini Str. 52, 20246, Hamburg, Germany.

Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2021 Apr;29(4):1106-1113. doi: 10.1007/s00167-020-06101-6. Epub 2020 Jun 17.

DOI:10.1007/s00167-020-06101-6

PMID:32556434

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7973925/

Abstract

PURPOSE

In cases of suspected rotational deformity of the lower limb, in particular in post-traumatic malalignment following closed nailing, there is a lack of adequate reference values. Available publications on leg rotation have either small sample sizes or do not include bilateral or whole leg rotation of healthy legs. This study aimed to determine side-specific reference values of lower limb rotation in a large healthy sample. This may be helpful in acute clinical settings as well as for medical expert opinion.

METHODS

226 consecutive bilateral lower limb computed tomography (CT) angiographies were screened. 105 patients (210 legs) were included (40 females, 65 males, mean age 67 ± 12 years). Bilateral axial femoral and tibial rotation alignment were independently measured and overall leg rotation was computed by two methods. Distributions, sex, and side differences were analyzed.

RESULTS

Two-sided paired t tests showed significant differences between right and left for all measurements. The left side showed a more pronounced mean anteversion in the femur of 2.2° (p = 0.002) and the right side higher mean external rotation in the tibia of 2.8° (p < 0.001). Overall leg rotation showed 5.1° more mean external rotation on the right side (p < 0.001) with both methods. Absolute side-to-side whole leg rotation difference was 9.5°. Absolute differences between both methods were 3.3°. The variance was high. 23 femora were retroverted, 1 tibia internally rotated, and 9 legs were overall internally rotated. No variables differed between female and male subjects except for femoral version (right p = 0.003 and left p = 0.002). Correlation coefficients were high (rho 0.550-0.934, all p < 0.001).

CONCLUSION

There is a significant prevalence of side-to-side asymmetry in femoro-tibial torsion. Although side-to-side differences are not extraordinary, comparative axial femoro-tibial rotation alignment should always be interpreted with caution.

LEVEL OF EVIDENCE

Diagnostic, retrospective cohort study, level III.

摘要

目的

在疑似下肢旋转畸形的情况下，特别是在闭合钉固定后创伤性对线不良的情况下，缺乏足够的参考值。关于腿部旋转的现有文献要么样本量小，要么不包括健康腿部的双侧或整个腿部旋转。本研究旨在确定大量健康样本中下肢旋转的特定侧参考值。这在急性临床环境中以及医学专家意见中可能会有所帮助。

方法

筛选了 226 例连续双侧下肢计算机断层扫描（CT）血管造影。纳入了 105 名患者（210 条腿）（40 名女性，65 名男性，平均年龄 67±12 岁）。独立测量双侧轴向股骨和胫骨旋转对线，并通过两种方法计算整个腿部旋转。分析了分布、性别和侧别差异。

结果

双侧配对 t 检验显示所有测量值的右-左差异均有统计学意义。左侧股骨的内旋均值为 2.2°（p=0.002），右侧胫骨的外旋均值为 2.8°（p<0.001），差异更明显。两种方法均显示右侧总腿部旋转的外旋均值多 5.1°（p<0.001）。右侧整个腿部的旋转差异为 9.5°。两种方法之间的绝对差异为 3.3°。方差较高。23 个股骨向后旋转，1 个胫骨向内旋转，9 个腿部整体向内旋转。除股骨版本（右侧 p=0.003，左侧 p=0.002）外，女性和男性受试者的变量均无差异。相关系数较高（rho 0.550-0.934，均 p<0.001）。