骶骨Ⅱ区骨折螺钉固定的影像解剖学研究

发布时间：2018-06-23 11:40

本文选题：骶骨Ⅱ区骨折 + 骶髂螺钉　；参考：《中国临床解剖学杂志》2015年04期

【摘要】：目的通过对骶髂关节三维重建模型进行解剖参数测量和虚拟骶髂螺钉固定,明确骶髂螺钉的最佳进钉点和安全置钉范围。方法用Mimics软件对50例骨盆CT数据进行三维重建,切割出骨盆三维模型,测量S1椎体解剖参数,在同一骶髂关节多次虚拟置钉,确定螺钉最佳进钉点,计算其安全角度。三维重建骨盆表面软组织,确定髂前上棘顶点N、髂嵴上点M、进钉点P的体表投影点N1、M1、P1,分段测量各投影点之间的长度。结果骶骨Ⅱ区中心螺钉骨面进钉点P到髂前上棘顶点N的距离PN男性为(95.17±5.59)mm,女性为(98.49±7.71)mm;经点P作PN的垂线与髂嵴交于点M,PM长度男性为(58.71±4.33)mm,女性为(54.59±6.01)mm;从髂前上棘顶点N沿髂嵴到点M的长度男性为(129.78±6.25)mm,女性为(130.64±7.79)mm,其中男女间PM长度有显著差异。中心螺钉前、后倾安全范围男性为(10.70±2.00)°,女性为(7.20±1.64)°;头、尾倾安全范围男性为(12.36±2.68)°,女性为(11.27±3.29)°,男性前、后倾安全范围明显大于女性。男女间体表投影点之间的长度仅P1M1有显著差异。结论通过触摸髂前上棘顶点N和髂嵴上的点M,可确定骶骨Ⅱ区骨折固定螺钉的体表进钉点。以S1椎体上表面为横截面,后表面为冠状面,男性螺钉前后倾安全范围约10°,头尾倾安全范围约12°,女性前后倾安全范围约7°,头尾倾安全范围约11°。
[Abstract]:Objective by measuring the anatomical parameters of the sacroiliac joint three-dimensional reconstruction model and the virtual sacroiliac screw fixation, the optimum insertion point and the safety nail range of the sacroiliac screw were determined. Methods the three-dimensional reconstruction of 50 cases of pelvic CT data was reconstructed with Mimics software, the three-dimensional model of the pelvis was cut, the anatomical parameters of the S1 vertebral body were measured, and the same sacroiliac joint was repeated many times. Virtual nailing was used to determine the best point of screw entry and to calculate the safety angle. Three-dimensional reconstruction of the soft tissue of the pelvis surface, the N of the anterior superior iliac spine, the M on the iliac crest, the surface projection point of the nail point P, N1, M1, P1, the length of each projection point. Results the distance between the central screw of the central screw of the sacrum and the distance N of the apex of the anterior superior iliac spine is PN male. For (95.17 + 5.59) mm, women were (98.49 + 7.71) mm; PN perpendicular to the iliac crest at point P was M, the length of PM was (58.71 + 4.33) mm, and female was (54.59 + 6.01) mm; the length of the vertex N along the iliac crest was (129.78 + 6.25) mm, and the female was (130.64 + 7.79) mm, among which the length of the male and female was significantly different. Before the central screw, The post tilt safety range was (10.70 + 2) and (7.20 + 1.64) degrees for women; the head and tail tilt safety range was (12.36 + 2.68) degrees and (11.27 + 3.29) degrees, and the rear safety range was obviously greater than that of women. The length of the projection points between men and women was only P1M1. Conclusion by touching the apex of the anterior upper spine of the iliac and the iliac crest Point M can determine the surface nail point of the fixed screw for the fracture of the sacral region. The upper surface of the S1 vertebral body is cross section, the posterior surface is the coronal plane, the safety range of the front and back tilt of the male screw is about 10 degrees, the safety range of the head and tail is about 12 degrees, the front and back safety range of the female is about 7 degrees, and the safety of the head and the tail is about 11 degrees.
【作者单位】：重庆医科大学附属第一医院骨科;重庆医科大学基础医学院解剖学教研室;重庆医科大学附属第一医院放射科;
【基金】：重庆市科委(cstc2012gg-yyjs0205) 重庆市渝中区科委(20110311)
【分类号】：R687.3;R322

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