经腹直肌外侧切口入路治疗髋臼骨折的解剖学研究

发布时间：2018-11-06 07:31

【摘要】：目的探讨经腹直肌外侧切口入路治疗髋臼骨折的安全性及临床应用价值。方法新鲜成人尸体标本5具(3男2女),同一尸体右侧腹壁行大体解剖,熟悉入路周围的解剖结构,左侧应用腹直肌外侧切口入路,模拟术中操作,显露骨盆环,进行解剖学观察,重点测量记录死亡冠血管相关解剖学参数。结果 (1)经腹直肌外侧入路的显露范围包括:耻骨联合至骶髂关节在内的真性骨盆环、髂骨翼、髋臼方形区和坐骨体内侧的髋臼后柱大部分。(2)根据对5具10侧骨盆的死亡冠统计分析发现,死亡冠的出现率为80%(8侧),直径为(2.1±1.9)mm,长为(4.7±0.5)cm,距离耻骨联合的距离为(4.9±0.4)cm。男女之间差异无明显统计学意义。结论经腹直肌外侧切口入路治疗髋臼骨折能够在不损伤重要神经血管的条件下,经腹膜外间隙对包括骶髂关节在内的大部分骨盆环结构进行显露。尤其方便显露结扎死亡冠,对髋臼后柱及髋臼内侧方形区的显露较传统入路有明显优势。
[Abstract]:Objective to evaluate the safety and clinical value of lateral incision of rectus abdominis in the treatment of acetabular fractures. Methods A total of 5 fresh adult cadavers (3 males and 2 females) underwent general anatomy of the right abdominal wall of the same cadaver and were familiar with the anatomical structure around the approach. The left lateral rectus abdominis incision approach was used to simulate the operation and reveal the pelvic ring. Anatomical observation was carried out, and the related anatomical parameters of dead coronal vessels were measured. Results (1) the exposure of the lateral approach to the rectus abdominis included the true pelvic ring and the iliac pterygoid from the pubic symphysis to the sacroiliac joint. (2) based on the statistical analysis of the dead crowns of 10 sides of the pelvis of 5 cadavers, the occurrence rate of the dead crowns was 80% (8 sides) and the diameter of the dead crowns was (2.1 卤1.9) mm,. The distance from pubic symphysis to (4.7 卤0.5) cm, is (4.9 卤0.4) cm.. There was no significant difference between men and women. Conclusion the treatment of acetabular fractures through lateral incision of rectus abdominis muscle can expose most of the pelvic ring structures including sacroiliac joints without damaging important nerve and blood vessels. It is especially convenient to expose and ligate the dead crown, which is superior to the traditional approach in exposing the posterior column of acetabulum and the medial square area of acetabular.
【作者单位】：南方医科大学第三附属医院创伤骨科广东省骨科研究院;
【分类号】：R687.3;R322

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