摘要
目的介绍开展双下肢全长负重位X线检查的方法,膝关节内外翻畸形的测量方法以及双下肢全长负重位X线片在全膝关节置换术中的临床应用价值。方法自2000年6月～2001年9月对27例(31膝)行全膝关节置换患者采用二次曝光或一次曝光法行术前、术后双下肢全长负重位X线检查,并比较两种成像方法的清晰度和结果的可靠性。在双下肢全长负重位X线片上膝关节内外翻畸形的测量方法:犤正常股骨远端外翻角(9°)-实际股骨外翻角度犦+犤实际胫骨近端内翻角-胫骨正常内翻角(3°)犦+犤实际关节内内外翻畸形度数-正常关节内内外翻畸形度数(0°)犦。结果二次曝光或一次曝光法双下肢全长负重位X线片成像均能显示全膝关节置换患者术前和术后下肢的力线、膝关节内外翻畸形和关节间隙方向,为全膝关节置换术术前评估提供了可靠的X线依据。在两种成像方法中,以采用一次曝光法成像相对清晰、可靠。结论双下肢全长负重位X线片对全膝关节置换术前计划和术后评估有重要的临床价值,一次曝光法成像清晰、可靠,能真实地反映术前膝关节内外翻畸形和术后畸形纠正结果。
Objective To introduce the technique of weight -bearing long X-rays of the lower ex-tremities and its value of clinical a pplication in total knee arthroplasty.Methods From June 2000to September 2001,the weight-bearing long X-rays of the lower extremities were taken in 27patients(31knees)pre-and postoperatively for total knee arthroplasty by the method of once exposure and twice exposure in one film.The definition and reliability of the films were compared within tw o methods of exposure.The calculating method of overall deformity of knee was:(9°normal valgus angle of distal femu r minus actual angle of valgus of the patient )+(actual varus angle of the patients t ibia minus 3°normal varus angle)+(actual intra-articular valgus or varus angle of the patient m inus 0°normal angle).Results Both of weight-bearing long X-ray film of the lower extremities by once exposure or twice exposure could show essentially alignment of the lower ex-tremity,deformity at the knee and th e joint-line orientation before and after total knee arthroplasty.The weight-bearing long X-ray film of tw o extremities might offer reliable material for preoperative planning f or total knee arthroplasty.Comparing to twi ce exposure,the once exposure was re latively clear and dependable.The deformities of knee according to calculating methods in this group inclu ded:varus angle over 30°in 2knees,varus between 20°and 30°in 3knees,v arus between 10°and 20°in 6knees,varus less than 10°in 11knees,normal angle in 2knees,valgus in 2knees less than 10°,valgus between 10°and 20°in 1knee,valgus between 20°and 30°in 4knees.Conclusion The weight-bearing long X-ray film o f lower extremities has an important clinical value in preoperative and postoperative evaluation of knee deformities in total knee arthro-plasty.The method of once exposure f or X-ray is more clear and reliable.T he weight-bearing long X-ray film shows essentially overall varus or v algus deformity at the knee itself before operation and the situation of prosthesis after the operation.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2002年第5期284-287,共4页
Chinese Journal of Orthopaedics
