髋臼后柱平行双螺钉数字化解剖学分析

doi:10.6040/j.issn.1671-7554.0.2016.1245

山东大学学报（医学版） ›› 2017, Vol. 55 ›› Issue (8): 82-87.doi: 10.6040/j.issn.1671-7554.0.2016.1245

髋臼后柱平行双螺钉数字化解剖学分析

余也¹,杨现伟²,徐波¹,闫奇¹,穆卫东¹

1.山东大学附属省立医院创伤骨科, 山东济南 250000;2.山东省汶上县人民医院骨科, 山东汶上 272500

收稿日期:2016-10-08 出版日期:2017-08-10 发布日期:2017-08-10
通讯作者: 穆卫东. E-mail:cola.daughter@163.com E-mail:cola.daughter@163.com
基金资助:
国家自然科学基金(81171708)

Digital anatomic basis of parallel double screws in the posterior column of the acetabulum

YU Ye¹, YANG Xianwei², XU Bo¹, YAN Qi¹, MU Weidong¹

1. Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250000, Shandong, China;
2. Department of Orthopaedics, Peoples Hospital of Wenshang County, Jining 272500, Shandong, China

Received:2016-10-08 Online:2017-08-10 Published:2017-08-10

摘要/Abstract

摘要： 目的探讨髋臼后柱能容纳两枚平行螺钉的安全区域以及获得两枚螺钉的相关参数。方法选取山东大学附属省立医院48例骨盆CT数据, 借助Mimics软件(15.0),在所有右侧髋臼后柱置入两枚平行圆柱体(代替螺钉),并测量两枚圆柱体的相关参数。结果后侧圆柱体:平均长度(L1)男(130.88±6.11)mm,女(121.47±5.23)mm; 到骨盆界线的距离(D1)男(19.65±2.45)mm, 女(17.89±2.00)mm; 到骶髂前关节面与骨盆界线交点的距离(S1)男(23.71±2.61)mm, 女(25.77±3.11)mm。前侧圆柱体:平均长度(L2)男(125.25±5.49)mm, 女(116.37±4.83)mm; 到骨盆界线的距离(D2)男(13.21±1.89)mm, 女(11.62±1.39)mm; 到骶髂前关节面与骨盆界线交点的距离(S2)男(24.36±3.95)mm, 女(28.15±4.70)mm。男患者圆柱体与水平面(α)、矢状面(β)、冠状面(γ)之间的平均角度分别为(66.18±4.40)°、(10.40±2.48)°、(20.89±5.05)°; 女患者分别为(69.01±5.25)°、(5.60±2.56)°、(19.91±5.58)°; 圆柱体最大半径(R)为6.00 mm。结论髋臼后柱有足够的空间容纳两枚相同半径的平行螺钉, 螺钉半径不超过6.00 mm。

关键词: 髋臼后柱, Mimics软件, 双螺钉, 解剖学

Abstract: Objective To provide a safe zone for double screws in the posterior column and to obtain the relevant parameters of two screws. Methods CT scan data of 48 pelvic specimens were analyzed. With the help of Mimics 15.0, 2 parallel cylinders(to substitute for screws)were implanted to the posterior column of the right side acetabulum, and the relevant parameters were measured. Results Posterior cylinder: The average length(L1)was(130.88±6.11)mm in males and(121.47±5.23)mm in females; the average distance(D1)to the linea terminalis was(19.65±2.45)mm in males and(17.89±2.00)mm in females; the average distance(S1)to the junction between the anterior border of iliosacral articulation and linea terminalis of pelvis was(23.71±2.61)mm in males and(25.77±3.11)mm in females. Anterior cylinder: The average length(L2)was(125.25±5.49)mm in males and(116.37±4.83)mm in females; the average distance(D2)to the linea terminalis was(13.21±1.89)mm in males and(11.62±1.39)mm in females; the average distance(S2)to the junction between anterior border of iliosacral articulation and linea terminalis of pelvis was(24.36±3.95)mm in males and(28.15±4.70)mm in females. The average angle 山东大学学报 (医学版)55卷8期 -余也,等.髋臼后柱平行双螺钉数字化解剖学分析 \=-between the cylinders and horizontal plane(α), sagittal plane(β), coronal plane(γ)was(66.18±4.40)°,(10.40±2.48)°,(20.89±5.05)° in males, and(69.01±5.25)°,(5.60±2.56)°,(19.91±5.58)° in females, respectively. The maximum radius of the cylinders was 6.00 mm. Conclusion There is sufficient space for 2 parallel cylinders with the same diameter in the posterior column of the acetabulum, with the maximum radius of the cylinders being less than 6.0 mm.

Key words: Posterior column, Double lag screws, Mimics software, Anatomy

中图分类号:

R641

余也,杨现伟,徐波,闫奇,穆卫东. 髋臼后柱平行双螺钉数字化解剖学分析[J]. 山东大学学报（医学版）, 2017, 55(8): 82-87.

YU Ye, YANG Xianwei, XU Bo, YAN Qi, MU Weidong. Digital anatomic basis of parallel double screws in the posterior column of the acetabulum[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(8): 82-87.

参考文献

[1] Black EA, Lawson CM, Smith S, et al. Open pelvic fractures: the University of Tennessee Medical Center at Knoxville experience over ten years[J]. Iowa Orthop J, 2011, 31: 193-198.
[2] Carroll EA, Huber FG, Goldman AT, et al. Treatment of acetabular fractures in an older population[J]. J Orthop Trauma, 2010, 24(10): 637-644.
[3] Ferguson TA, Patel R, Bhandari M, et al. Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study[J]. J Bone Joint Surg Br, 2010, 92(2): 250-257.
[4] Mears DC. Surgical treatment of acetabular fractures in elderly patients with osteoporotic bone[J]. J Am Acad Orthop Surg, 1999, 7(2): 128-141.
[5] Judet R, Judet J, Lanzetta A, et al. Factures of the acetabulum: classification and guiding rules for open reduction[J]. Arch Orthop, 1968, 81(3): 119-158.
[6] Letournel E, Peltier LF, Johnson EE. Fractures of the acetabulum: a study of a series of 75 cases[J]. Clin Orthop Relat Res, 1994(305): 5-9.
[7] Kellam JF, McMurtry RY, Paley D, et al. The unstable pelvic fracture: Operative treatment[J]. Orthop Clin North Am, 1987, 18(1): 25-41.
[8] Routt Jr ML, Simonian PT, Swiontkowski MF. Stabilization of pelvic ring disruptions[J]. Orthop Clin North Am, 1997, 28(3): 369-388.
[9] Vallier HA, Cureton BA, Ekstein C, et al. Early definitive stabilization of unstable pelvis and acetabulum fractures reduces morbidity[J]. J Trauma, 2010, 69(3): 677-684.
[10] Mu WD, Wang XQ, Jia TH, et al. Quantitative anatomic basis of antegrade lag screw placement in posterior column of acetabulum[J]. Arch Orthop Trauma Surg, 2009, 129(11): 1531-1537.
[11] Goulet JA, Bray TJ. Complex acetabular fractures[J]. Clin Orthop Relat Res, 1989(240): 9-20.
[12] Schopfer A, DiAngelo D, Hearn T,et al. Biomechanical comparison of methods of fixation of isolated osteotomies of the posterior acetabular column[J]. Int Orthop, 1994, 18(2): 96-101.
[13] Ebraheim NA, XU R, Biyani A, et al. Anatomic basis of lag screw placement in the anterior column of the acetabulum[J]. Clin Orthop Relat Res, 1997, 339: 200-205.
[14] Gay SB, Sistrom C, Wang GJ, et al. Percutaneous screw fixation of acetabular fractures with CT guidance: preliminary results of a new technique[J]. AJR Am J Roentgenol, 1992, 158(4): 819-822.
[15] Chang JK, Gill SS, Zura RD, et al. Comparative strength of three methods of fixation of transverse acetabular fractures[J]. Clin Orthop Relat Res, 2001(392): 433-441.
[16] Mouhsine E, Garofalo R, Borens O, et al. Percutaneous retrograde screwing for stabilisation of acetabular fractures[J]. Injury, 2005, 36(11): 1330-1336.
[17] Tseng S, Tornetta P. 3rd. Percutaneous management of Morel-Lavallee lesions[J]. J Bone Joint Surg Am, 2006, 88(1): 92-96.
[18] Starr AJ, Reinert CM, Jones AL. Percutaneous fixation of the columns of the acetabulum: a new technique[J]. J Orthop Trauma, 1998, 12(1): 51-58.
[19] Goldstein A, Phillips T, Sclafani SJ, et al. Early open reduction and internal fixation of the disrupted pelvic ring[J]. J Trauma, 1986, 26(4): 325-333.
[20] Xu P, Wang H, Liu ZY, et al. An evaluation of three-dimensional image-guided technologies in percutaneous pelvic and acetabular lag screw placement[J]. J Surg Res, 2013, 185(1): 338-346.
[21] Ochs BG, Stuby FM, Ateschrang A, et al. Retrograde lag screw placement in anterior acetabular column with regard to the anterior pelvic plane and midsagittal plane-virtual mapping of 260 three-dimensional hemipelvises for quantitative anatomic analysis[J]. Injury, 2014, 45(10): 1590-1598.
[22] Krishnan V, Varghese V, Kumar GS. Comparative analysis of effect of density, insertion Angle and reinsertion on pull-out strength of single and two pedicle screw constructs using synthetic bone model[J]. Asian Spine J, 2016, 10(3): 414-421.
[23] 王先泉, 张伟, 孙水, 等. 髋臼前柱拉力螺钉技术内固定的临床解剖学研究[J]. 中国临床解剖学杂志, 2007, 25(2): 143-147. WANG Xianquan, ZHANG Wei, SUN Shui, et al. Clinical anatomic study of internal fixation of acetabular anterior column lag screw technique[J]. Chinese Journal of Clinical anatomy, 2007, 25(2): 143-147.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed

髋臼后柱平行双螺钉数字化解剖学分析

Digital anatomic basis of parallel double screws in the posterior column of the acetabulum

PDF (PC)

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 2

多维度评价

本文评价

推荐阅读 0

[1]	林令博1，熊春梅1，韩梅1，孔祥荣1，王道才2，李建志1，邵江1，林祥涛2，肖连祥2. 胰腺冠状断层解剖与多层螺旋CT冠状位图像研究[J]. 山东大学学报(医学版), 2012, 50(9): 86-.
[2]	王丽娟1,2，王光彬2，刘玉波3，耿明宾4，胡建滨1，白雪1，赵连新1. 脑干梗死的一种特殊MR征象分析[J]. 山东大学学报(医学版), 2011, 49(5): 111-.