台灣人股骨髓前曲半徑和骨髓內釘比較之電腦斷層研究

Abstract

摘要 諸多研究發現醫院使用之骨髓內釘及患者的股骨髓前曲半徑不相配合，然而尚未有研究探討骨髓內腔(the intramedullary canal)本身之曲率，因此本研究將針對股骨髓內腔之曲率做深入的探討。

本研究使用電腦斷層圖像尋找每張骨髓內腔切片之中心點，並用此估計樣本骨髓內腔之中心點，並利用估計之中心點計算前曲半徑，藉此再與骨髓內釘之曲率做比較。本研究實驗之樣本資料來自於3名女性及9名男性病患，總共納入18筆樣本資料，其中包括5筆女性及13筆男性之股骨資料。

本研究結果之股骨髓內腔的前曲半徑平均為884毫米±678毫米，並且男性和女性之股骨髓內腔曲率有顯著的不同，特別是在股骨遠端(distal)、股骨骨幹(shaft)以及股骨近端(proximal)之部份，男女股骨髓內腔曲率不同。當本研究比較台灣人平均之股骨髓前曲半徑及醫院使用之骨髓內釘時，發現其兩者半徑並不相配，甚至其中一隻最彎曲之骨髓內釘（其曲率半徑達到1860毫米），對於平均骨髓內腔來說仍然過於筆直，因此本研究建議骨髓內釘之曲度應增加，藉此才能更好地配合病患的股骨髓前區半徑。

Abstract A mismatch in the radius of curvature between the design of intramedullary nails and the femur bone has been shown by various studies. The curvature of the intramedullary canal itself however has not been looked up on. This study is looking at the intramedullary curvature, only considering the canal itself. CT images are used to find the center points of the intramedullary canal at each slice to estimate the center of the intramedullary canal. These points are used to calculate the radius of curvature and compare it to nails curvatures. For the experiment a total of 18 specimens are used from 5 female and 13 male bones, out of 3 female and 9 male patients all who are Taiwanese. The intramedullary canal’s radius of curvature has an average of 884 mm ± 678 mm and the curvature between male and female differs overall. It can be even more specified, specific at the distal, shaft and proximal part of the femur. When comparing the average radius of curvature to the nails used, a miss match of the radius is found. One of the most bowed nails with 1860 mm radius of curvature is much straighter than the average intramedullary canal’s radius. Considering these results the radius of curvature of the nail should be more curved to better fit the average radius of curvature of the Taiwanese femur.