喙锁韧带重建中锁骨钻孔位置的数字解剖学

发布时间：2018-04-06 22:33

本文选题：锁骨　切入点：韧带　出处：《中国组织工程研究》2015年42期

【摘要】：背景:经喙锁骨道的喙锁韧带重建是一种治疗肩锁关节脱位的有效方法,锁骨钻孔位置直接决定骨道的质量及治疗的成败。目的:观察锁骨不同钻孔位置对喙锁韧带重建过程中骨道位置的影响。方法:使用Mimics 13.0软件对60个肩部的CT影像资料进行重建得到喙锁结构模型。根据目前2种主流喙锁韧带重建方案的钻孔位置及一种作者提出的理想的钻孔位置在模型上虚拟手术建立骨道,并进行相关的测量以评估其安全性。方案1:钻孔位置距锁骨远端30 mm,位于锁骨表面前后缘的正中;方案2:钻孔位置距锁骨远端40 mm,位于锁骨表面前后缘的正中;方案3:与锥状结节尖端和喙突基底部的中点在同一直线上,在锁骨上表面的后缘。结果与结论:重建方案1的喙突骨道在男性模型中过于偏内侧。重建方案1和2的骨道均不在锁骨正中。重建方案3的喙突及锁骨骨道均位于正中。以距离锁骨远端一个固定数值来确定钻孔位置的方法在男女性的模型中得到的骨道差异很大。锁骨端的钻孔位置应与锥状结节尖端和喙突基底部的中点在同一直线上,并且应靠锁骨上表面的后缘,才能保证喙突及锁骨骨道的居中。
[Abstract]:Background: coracoclavicular ligament reconstruction is an effective method for the treatment of acromioclavicular joint dislocation.Aim: to observe the influence of different hole positions of clavicle on the location of coracoclavicular ligament during coracoclavicular ligament reconstruction.Methods: the coracoclavicular structure model was reconstructed from 60 shoulder CT images by Mimics 13.0 software.According to the drilling position of two kinds of mainstream coracoclavicular ligament reconstruction schemes and an ideal drilling location proposed by the author, the bone canal was established by virtual surgery on the model, and the safety was evaluated by relevant measurements.Scheme 1: the borehole position is 30 mm from the distal clavicle, which is located in the middle of the anterior and posterior edge of the clavicle surface, and the borehole position is 40 mm from the distal clavicle, which is located in the middle of the anterior and posterior edge of the clavicle surface.Scheme 3: in line with the tip of the conical nodule and the midpoint at the base of the coracoid, the posterior edge of the supraclavicular surface.Results and conclusion: the coracoid process of the reconstruction scheme 1 was too medial in the male model.Neither the osseous tract of the reconstruction schemes 1 nor 2 was in the middle of the clavicle.Both the coracoid process and the clavicle were located in the middle of reconstruction plan 3.The method of determining the location of borehole by a fixed value at the distal end of the clavicle is very different in the male and female models.The drilling position of the clavicle should be in line with the tip of the conical nodule and the middle point of the coracoid base, and the center of the coracoid process and the clavicle should be ensured by the posterior edge of the upper surface of the clavicle.
【作者单位】：上海交通大学医学院附属新华医院崇明分院骨科;
【基金】：上海市高等职业教育重点专业建设(085工程)(FY(14)700-A5-1-17,FY(15)700-A6-1-10)~~
【分类号】：R687.3;R322

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