Abstract：Objective To analyze the anatomical data of southwestern region and to investigate the morphological analysis of normal distal segment tibia, as the basis for the design of new diaphysis prosthesis for limit bone defects of distal tibial.Methods A retrospective study in West China Hospital of Sichuan University from January 2014 to October 2017 was carried out. One hundred and seven CT data of normal tibia were gathered, including 57 males and 50 females with the age of 20-40(29.8±5.2) years old. The relevant anatomical data were measured by Mimics software. It included the length between upper and lower articular surface(L1), the length from upper articular surface to the upper margin of isthmus(L2) , the length of the shortest tibial length that could retain the distal tibiofibular ligament (L4),the length on the narrow segment(L5),the mean thickness of the thinnest cortex at the narrowest part of isthmus(L6), the diameter of the narrowest part of isthmus(D1) ,the thickness of the thinnest cortex at the narrowest part of isthmus, the major and minor axes of the most suitable ellipse for the medullary cavity above the distal tibial articular surface 4 cm (D2 and D3), the angle between D2 and coronal axis(∠α) and so on. Two independent sample t-tests were used to analyze whether the above parameters were different in gender, and their correlation with height was analyzed by Pearson test; anatomical observation was performed by CT images. The size and shape of the medullary cavity in the distal segment of the tibia and the size and relative position of the medullary cavity in the upper and lower osteotomies were analyzed.Results L1 was (339.0±22.2) mm, L2 was (210.0±20.2) mm, L4 was(27.0±4.3)mm, L5 was(56.5±15.0)mm, L6 was(3.6±0.6)mm, D1 was(10.2±1.6)mm, D2 and D3 were(22.2±2.5)mm and(18.1±2.5)mm,∠α was 32.8±24.7°. L1, L2, L6, D1, D2 and D3 had positive correlation with height(r=0.212-0.793, all P values＜0.05), and males were significantly larger than females(all P values＜0.05), the length of the shortest tibia, which remained distal tibiofibular ligament(S1), was negatively correlated with height(r=-0.199, P＜0.05), but there was no significant difference between males and females(P values＞0.05). While the other anatomical data didnt(all P values＞0.05). When the residual length of distal tibial was ≤4 cm, the medullary cavity was an “inverse funnel”. In the coronal plane, the tibial mechanical axis was located approximately 18.5%±6.5% inward of the anatomical axis in the coronal plane; in the sagittal plane, the tibial mechanical axis was located approximately 34.5%±4.7% posterior to the anatomical axis, so the position of the distal stem of the prosthesis should approach the medial and posterior cortex.Conclusionse The tibia has its CT imaging characteristic, and the characteristic should be used to determine the basic shape of the prosthesis, and then different gradient models should be designed according to the variables.
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2018, Vol. 23 
