来源：304关节学术

译者：罗殿中

整理：骨科在线

双平面X线摄影、轴向X线摄影和透视法是常用的放射学股骨颈前倾角测量方法。这些方法遵循的是严格几何意义的前倾角。随着CT测量股骨颈前倾角方法的出现，现在已经被广泛使用，但是基于CT的测量并不符合公认的前倾定义，且没有经过大样本的测试进行准确性评估。

在1987年，由Murphy SB,Simon SR, Kijewski PK等人开发了一种使用CT测量前倾角的新方法，并命名为Murphy法。他们通过广泛应用的CT技术对32个股骨标本进行前倾角测量。与直接测量法相比，CT测量法的数值比直接测量法平均高10°，且重复测量的误差在±3.6°以内。使用Murphy法在同一样本上重复测量，误差在±1°。这项研究从几何学上证明了为什么目前应用的CT法选点定义的股骨颈轴线与几何上的前倾角定义不一致。Murphy法描述了一种可准确定义股骨颈轴线并测量股骨颈前倾角的方法，推荐用于临床。

测量方法

Murphy法测量股骨颈前倾角示意图

选择一个股骨头层面（a），确定股骨头中心（H），选择股骨颈基底部层面（b）确定股骨颈基底部中心（O），选择股骨髁层面（c）确定膝关节轴线，股骨颈轴线（H与O的连线）与股骨髁轴线的夹角为股骨颈前倾角

原文摘要

Femoral anteversion

Biplane roentgenography, axial roentgenography, and fluoroscopy are the usual roentgenographic methods of measuring femoral anteversion. These methods use a strict geometrical definition of anteversion. The computerized tomography method of measuring anteversion that was developed recently, and is now widely used, does not adhere to the accepted definition of anteversion and has not been tested for accuracy in a large series. In the present study, the widely used computerized-tomography method of measuring anteversion was tested on thirty-two femoral specimens. With that method, anteversion was consistently underestimated by an average of 10 degrees compared with direct measurements and was reproducible only to within +/- 3.6 degrees. Therefore, a new method of measuring anteversion using computerized tomography was developed. It was shown to be accurate to +/- 1 degree, as tested on the same specimens. This study demonstrated geometrically why the currently practiced computerized-tomography method of selecting the points that are used to define the axis of the femoral neck is not consistent with geometrical definitions of anteversion. A more accurate method for both defining the axis of the femoral neck and measuring femoral anteversion is described and recommended for clinical use.

文献出处：Murphy SB, Simon SR, Kijewski PK, Wilkinson RH, Griscom NT. Femoral anteversion。J Bone Joint Surg Am. 1987 Oct;69(8):1169-76.