髋臼后柱内固定技术和髂骨的局部定量解剖学研究

发布时间：2018-11-25 08:39

【摘要】：一、研究背景近年来骨盆创伤的治疗获得了长足的进步,切开复位内固定(Open Reduction and Internal Fixation,ORIF)成为骨盆骨折和髋臼骨折的一种重要治疗手段,在骨盆内固定过程中有时会发生螺钉穿入关节内、损伤盆腔内重要血管或神经等严重并发症,因此了解骨盆各个部位的厚度、重要血管和神经距骨壁的距离以及它们在骨盆表面的投影是防止发生血管和神经意外损伤的基础和关键。虽然国外一些学者相继报道了后柱拉力螺钉技术,但这些学者使用的技术中的螺钉的进钉点、方向和长度均不相同,缺乏统一性,螺钉穿入关节内或损伤重要的血管和神经的危险较大,因此通过定量解剖学研究,寻找螺钉的最佳进钉点、方向和长度是减少上述并发症的关键。目前有关后柱拉力螺钉技术的定量解剖学文献极少,而且他们确定螺钉进钉点的方法过于繁琐,临床使用不方便。目前关于整个骨盆厚度的研究未见文献报道,我们在骨盆的内侧面和外侧面分别建立一个坐标系,测量出坐标系中各点的厚度,画出等厚线,在不同的等厚线之间分别用不同的颜色填充,形成几个不同的厚度区域。除髂外血管、闭孔血管神经束、骶髂关节、骶骨侧块或骶2椎弓根外,骨盆内其他的重要结构在髂骨外板的体表投影未见文献报道。
[Abstract]:Background: in recent years, great progress has been made in the treatment of pelvic trauma. Open reduction and internal fixation (Open Reduction and Internal Fixation,ORIF) has become an important treatment for pelvic fractures and acetabular fractures. In the course of pelvic internal fixation, serious complications such as screw penetration into the joint and injury of important blood vessels or nerves in the pelvic cavity occur, so the thickness of each part of the pelvis is understood. The distance between the important blood vessels and the talus wall and their projection on the pelvic surface are the basis and key to prevent the accidental injury of blood vessels and nerves. Although some foreign scholars have reported on the technique of rear column pull screw, the point, direction and length of screw in the technique used by these scholars are different and lack of uniformity. The risk of screws penetrating into joints or damaging important blood vessels and nerves is greater, so finding the best point of screw entry through quantitative anatomical study, direction and length is the key to reduce the complications mentioned above. At present, there are few quantitative anatomical literatures on the technique of posterior column pull screw, and their method of determining the point of screw entry is too cumbersome and inconvenient for clinical use. At present, there is no literature report on the whole pelvis thickness. We set up a coordinate system on the inner and outer sides of the pelvis, measure the thickness of each point in the coordinate system, draw the equal thickness line. Different thickness lines are filled with different colors to form several different thickness regions. Except for the external iliac vessels, obturator vascular nerve bundles, sacroiliac joints, sacrum lateral mass or sacral pedicle, other important structures in the pelvis have not been reported in the body surface projection of the iliac external plate.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R687.3;R322

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