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目的 通过对青海省200名大骨节病病区人群右手掌指骨X线测量,了解大骨节病患者掌指骨的基本情况,为临床诊断、手外科的应用提供解剖学资料和参考依据.方法 2013年,在青海省海南州贵德县、兴海县、同德县大骨节病病区,对200名居民右手掌指骨进行X线拍片,按照《大骨节病诊断标准》,78名大骨节病X线阳性者作为病例组,其他122名作为对照组.使用电子游标卡尺进行掌指骨X线测量,记录掌指骨轴长、横径,并计算掌指骨指数.结果 男、女性人群掌骨轴长均表现出第二掌骨＞第三掌骨＞第四掌骨＞第五掌骨＞第一掌骨的特征(F=152.892、266.452,P均＜0.01).其中病例组男性第三、四、五掌骨、所有指骨近节、中节,食指、无名指、小拇指末节的轴长[(62.08±3.22)、(55.56±3.43)、(51.29±3.35)、(27.73±1.58)、(37.07±2.10)、(20.41±1.53)、(42.58±2.27)、(24.67±1.93)、(40.36±2.46)、(23.80±1.65)、(31.71±1.76)、(16.67±1.84)、(14.77±1.37)、(16.00±1.41)、(14.86±1.35)mm]均低于对照组[(65.06±3.01)、(58.23±3.04)、(52.60±7.74)、(29.73±1.87)、(39.34±1.81)、(22.31±1.73)、(44.69±2.39)、(26.73±1.81)、(42.48±2.04)、(25.72±1.84)、(33.22±1.88)、(18.23±1.94)、(15.81±2.66)、(17.12±2.95)、(16.07±1.23) mm,P均＜0.05];病例组女性食指、无名指、小拇指近节轴长[(36.32±2.54)、(39.14±2.64)、(30.51±2.02)mm]均低于对照组[(37.40±2.04)、(40.06±2.13)、(31.31±1.75)mm,P均＜0.05].病例组男性掌骨指数[(7.54±0.71)mm]和食指、中指、无名指近节指骨指数[(4.03±0.29)、(4.33±0.32)、(4.44±0.41)mm]低于对照组[(8.05±0.68)、(4.27±0.43)、(4.58±0.36)、(4.71±0.38)mm,P均＜0.01];女性患者食指、中指中节指骨指数[(3.42±0.32)、(3.75±0.46)mm]低于对照组[(3.65±0.53)、(4.03±0.42)mm,P均＜0.05].结论 青海省大骨节病患者掌指骨轴长短于病区健康成年人,性别间存在一定差异.手骨X线测量可以为大骨节病诊断及手外科的应用提供解剖学资料和参考依据.“,”Objective By X-ray measurement of metacarpal and phalange bones in the right hand of 200 adults in Kaschin-Beck disease (KBD) regions,Qinghai Province,to understand the basic conditions of metacarpal and phalange bones in adult patients with KBD,and to provide anatomic data and information for clinic diagnosis and application of hand surgery.Methods In 2013,200 adults in KBD areas were taken right hand X-ray examination in Xinghai,Guide and Tongde KBD endemic areas in Qinghai Province.According to “The Diagnostic Standard of Kaschin-Beck Disease”,78 adult patients with KBD were diagnosed by X-ray,others were healthy control group,then metacarpal and phalange bones were measured with electronic digital vernier caliper,the axis length and width of metacarpal and phalange bone s were recorded,and index of metacarpal and phalange bones were calculated.Results The axis lengths of metacarpal bones of 200 people were 2.metacarpal ＞ 3.metacarpal ＞ 4.metacarpal ＞ 5.metacarpal ＞ 1.metacarpal (F =152.892,266.452,all P ＜ 0.01).Among them,the axis lengths of 3,4,5 metacarpal bones,proximal,middle of phalange bones and distal of 4,5 phalange bones in male patients [(62.08 ± 3.22),(55.56 ± 3.43),(51.29 ± 3.35),(27.73 ± 1.58),(37.07 ± 2.10),(20.41 ± 1.53),(42.58 ± 2.27),(24.67 ± 1.93),(40.36 ± 2.46),(23.80 ± 1.65),(31.71 ± 1.76),(16.67 ± 1.84),(14.77 ± 1.37),(16.00 ± 1.41),(14.86 ± 1.35)mm] were significantly lower than those from healthy control group [(65.06 ± 3.01),(58.23 ± 3.04),(52.60 ± 7.74),(29.73 ± 1.87),(39.34 ± 1.81),(22.31 ± 1.73),(44.69 ± 2.39),(26.73 ± 1.81),(42.48 ± 2.04),(25.72 ± 1.84),(33.22 ± 1.88),(18.23 ± 1.94),(15.81 ± 2.66),(17.12 ± 2.95),(16.07 ± 1.23)mm,all P ＜ 0.05]; The axis lengths of 2,4,5 proximal phalange bones in female patients [(36.32 ± 2.54),(39.14 ± 2.64),(30.51 ± 2.02)mm] were significantly lower than those from healthy control group [(37.40 ± 2.04),(40.06 ± 2.13),(31.31 ± 1.75)mm,all P ＜ 0.05].The indexes metacarpal and phalange bones of KBD patients were shorter than those from healthy control group.Among them,the metacarpal bone index [(7.54 ± 0.71)mm] and index of proximal phalange bones of 2,3,4 [(4.03 ± 0.29),(4.33 ± 0.32),(4.44 ± 0.41)mm] in male patients were significantly lower than those from healthy control group [(8.05 ± 0.68),(4.27 ± 0.43),(4.58 ± 0.36),(4.71 ± 0.38)mm,all P ＜ 0.01].The indexes of middle phalange bones of 2,3 [(3.42 ± 0.32),(3.75 ± 0.46)mm] in female patients were significantly lower than those from healthy control group [(3.65 ± 0.53),(4.03 ± 0.42)mm,all P ＜ 0.05].Conclusion The axis lengths of metacarpal and phalange bones of adult patients with Kaschin-Beck Disease are shorter than those from healthy control group,and X-ray measurement of hand could provide anatomic data and information for KBD diagnosis and application of hand surgery.