经皮逆行髋臼前柱螺钉内固定的计算机辅助应用解剖学研究

发布时间：2018-03-09 07:30

本文选题：髋臼前柱螺钉　切入点：经皮　出处：《中国矫形外科杂志》2017年16期 　论文类型：期刊论文

【摘要】：[目的]测量经皮逆行髋臼前柱螺钉内固定的应用解剖参数。[方法]收集本院2015年6月~2016年1月完整骨盆CT扫描数据男女各15例(男女各30侧半骨盆),应用Mimics计算机辅助外科软件,重建骨盆三维模型。模拟手术逆行置入髋臼前柱虚拟螺钉,调整好螺钉位置后测量螺钉长度、进钉点、进钉方向;通过软件的重切割功能,制作35层髋臼前柱系列截面,测量截面中螺钉所通过位置(即钉道)的直径。[结果]髋臼前柱可置入螺钉的最大工作长度男女分别为(119.79±8.71)mm、(104.10±5.84)mm;进钉点(P)到耻骨上支上缘(A)、耻骨联合(B)的垂直距离男性分别为(19.69±2.79)mm、(18.80±3.35)mm,女性分别为(18.27±2.13)mm、(22.92±3.34)mm;螺钉与冠状面、矢状面、横切面的夹角男性依次为(16.18±5.37)°、(41.76±4.78)°、(43.30±5.55)°,女性依次为(17.16±5.53)°、(43.12±3.90)°、(41.36±4.59)°;螺钉长度和PB男女之间的差异具有统计学意义(P0.05),进钉方向和PA男女之间的差异无统计学意义(P0.05)。前柱钉道最狭窄处位于第5层,该层截面中钉道直径男女分别为(11.43±1.24)mm、(8.75±0.95)mm,男女之间差异具有统计学意义(P0.05)。[结论]作者建议国人男性使用直径为6.5 mm的螺钉,女性使用直径为5.5 mm的螺钉;进钉点男女稍有不同,在螺钉经过耻骨上支的中部和髂窝平面处两个狭窄地方时,应加强监视。
[Abstract]:[objective] to measure the applied anatomical parameters of percutaneous retrograde anterior column screw fixation of acetabular anterior column. [methods] 15 male and 15 male patients (30 sides of hemipelvis, male and female) with complete pelvic CT scan data from June 2015 to January 2016 were collected from our hospital. Computer aided surgery software, Reconstruction of the pelvis 3D model. Simulated surgery retrograde placement of the acetabular anterior column virtual screw, adjust the screw position after measuring the screw length, nail point, the direction of the nail, through the software recutting function, make 35 layers of acetabular anterior column series section, The diameter of the screw through the cross section was measured. [results] the maximum working length of the screw was 119.79 卤8.71 mm for males and 104.10 卤5.84 mm for males and females, respectively. It was 19.69 卤2.79 mm and 18.80 卤3.35 mm respectively, and that of female was 18.27 卤2.13 mm and 22.92 卤3.34 mm respectively. In sagittal plane and transverse plane, the angle between male and female was 16.18 卤5.37 掳/ 41.76 卤4.78 掳/ 43.30 卤5.55 掳respectively, and that of female was 43.12 卤3.90 掳/ 41.36 卤4.59 掳respectively. The diameter of the nail passage in this layer was 11.43 卤1.24 mm and 8.75 卤0.95mm, respectively. The difference between male and female was statistically significant (P 0.05). [conclusion] the author suggests that the male should use the screw with the diameter of 6.5 mm and the female with the diameter of 5.5 mm, and the point of insertion is slightly different between the male and the female. Surveillance should be strengthened when screws pass through the middle of the superior pubic branch and at the level of the iliac fossa.
【作者单位】：广州军区武汉总医院骨科;湖北中医药大学;
【基金】：湖北省自然科学基金项目(编号:2014CFC1052) 湖北省卫生计生西医类一般项目(编号:WJ2015MB119) 广州军区武汉总医院青年基金项目(编号:YZ201501)
【分类号】：R322.7;R687.3

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