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一种预测复发性髌骨脱位患者股骨前倾角过大的新因素。

A new factor predicting excessive femoral anteversion in patients with recurrent patellar dislocation.

机构信息

Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Ziqiang Road 139, Shijiazhuang, 050051, Hebei, China.

出版信息

J Orthop Surg Res. 2022 Jul 28;17(1):366. doi: 10.1186/s13018-022-03259-2.

Abstract

PURPOSE

Determining a new imaging method on full-leg standing lower limb radiographs to predict excessive femoral anteversion in patients with patellar dislocation.

METHODS

This study included 119 patients with patellar dislocation from January 2014 to January 2021. The femoral anteversion and tibial torsion were measured by CT scanning. The medial condylar angle was measured by the full-leg standing lower limb radiographs. Pearson correlation coefficient was used to evaluate the correlation between rotation parameters and medial condylar angle.

RESULTS

Included patients were divided into DFO group and control group according to whether they received derotational femoral osteotomy (DFO) operation or not. DFO group had significantly higher femoral anteversion (29.8° ± 7.2° vs 23.1° ± 6.5°, P < 0.05), higher tibial torsion (28.6° ± 6.9° vs 24.7° ± 7.9°, P < 0.05), lower medial condylar angle (154.8° ± 4.7° vs 157.5° ± 6.7°, P < 0.05) than control group. Correlation analysis showed that the values of femoral anteversion were significantly correlated with medial condylar angle (r = -0.719, P < 0.001).

CONCLUSION

This study showed that medial condylar angle had a negative correlation with excessive femoral anteversion on the full-leg standing lower limb radiographs. The medial condylar angle can be a good predictor of femoral anteversion and can be used to guide the performance of DFO to treat patellar dislocation in clinical practice.

摘要

目的

在全下肢站立位下肢 X 线片上确定一种新的影像学方法,以预测髌骨脱位患者的股骨过度前倾。

方法

本研究纳入 2014 年 1 月至 2021 年 1 月期间 119 例髌骨脱位患者。通过 CT 扫描测量股骨前倾角和胫骨扭转。通过全下肢站立位下肢 X 线片测量内侧髁角。采用 Pearson 相关系数评估旋转参数与内侧髁角的相关性。

结果

根据是否接受股骨旋转截骨术(DFO),将纳入患者分为 DFO 组和对照组。DFO 组股骨前倾角(29.8°±7.2° vs 23.1°±6.5°,P<0.05)、胫骨扭转(28.6°±6.9° vs 24.7°±7.9°,P<0.05)、内侧髁角(154.8°±4.7° vs 157.5°±6.7°,P<0.05)均明显高于对照组。相关性分析显示,股骨前倾角值与内侧髁角呈显著负相关(r=-0.719,P<0.001)。

结论

本研究表明,全下肢站立位下肢 X 线片上的内侧髁角与股骨过度前倾呈负相关。内侧髁角可作为股骨前倾角的良好预测指标,可用于指导临床实践中 DFO 治疗髌骨脱位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1266/9330675/8d5e39ca66b2/13018_2022_3259_Fig1_HTML.jpg

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