基于CT下对于髋臼四边体骨折采用直接固定置钉相对安全区的测量研究
发布时间：2018-08-11 09:50
【摘要】：目的:测量出采用空心拉力螺钉直接固定髋臼四边体的安全区的位置方法:获取于2014年2月~2014年12月采用我院宝石能谱CT对骨盆进行CT扫描的成年患者数据,重新重建出按平行于前柱方向且垂直于四边体内侧面的平面重建出新扫描图片,男50例,女50例。以4.5mm空心拉力螺钉为标准,在重建下的CT上接测量得出以垂直于髋臼前柱并平行于髋臼四边体内侧面的方向,通过螺钉的安全通道的范围。结果:经实际测量得出,髋臼四边体区域可容纳4.5mm空心拉力螺钉的安全区域上限为,男性的平均髋臼L1值为(6.45±4.83)mm,平均髋臼L2值为(38.80±7.00)mm,女性的平均髋臼L1值为(11.68±4.69)mm,平均髋臼L2值为(34.73±6.06)mm。男性的髋臼处平均L1值与与女性的髋臼处平均L1值平均比较得出差异有统计学意义,P=0.02。男性的髋臼处平均L2值与女性的髋臼处平均L2值比较差异没有统计学意义(P0.05),得出成年人髋臼安全区的平均L2值为(36.67±6.77)mm。手术中采用复位后使用空心钉直接固定骨盆四边体时经垂直于髋臼前柱的方向,紧贴四边体的内侧面置钉,在以B点作为参照时小于(36.67±6.77)mm或以E点作为参照时男性小于(6.45±4.83)mm、女性小于(11.68±4.69)mm,可以容纳4.5mm空心拉力螺钉安全通过。结论:在术前采用CT重建测量的方法,可以得到髋臼相对安全区的数据,制定个性化方案,指导术中安全、快速安置经四边体的螺钉,并且节约花费。对于有髋关节炎或者股骨头坏死的患者不能以本研究的结果作为参考,需谨慎把握手术适应症。
[Abstract]:Objective: to measure the position of the safe area of acetabular quadrangular body fixed directly by hollow pull screw. Methods: to obtain the data of adult patients who underwent CT scanning of pelvis with sapphire energy spectrum CT from February 2014 to December 2014. A new scan image was reconstructed from the plane parallel to the anterior column and perpendicular to the four sides of the body, 50 males and 50 females. Using 4.5mm hollow pull screw as the standard, the range of safety passage through the screw was obtained in the direction perpendicular to the anterior column of the acetabular and parallel to the inside side of the four sides of the acetabulum. Results: the upper limit of safe area for the 4.5mm hollow lapping screws in the acetabular quadrangular area was (6.45 卤4.83) mm for males, (38.80 卤7.00) mm for acetabular L2, (11.68 卤4.69) mm for females, and (34.73 卤6.06) mm for females. The average L1 value of acetabular in males and females was significantly higher than that in females. There was no significant difference between male and female acetabular average L2 values (P0.05). The average L2 value of adult acetabular safety zone was (36.67 卤6.77) mm. During the operation, the pelvis quadrilateral body was fixed directly by hollow nail after reduction, which was perpendicular to the anterior column of the acetabulum and attached to the medial side of the quadrilateral body. When point B is taken as reference point, it is less than (36.67 卤6.77) mm or when point E is used as reference, male is less than (6.45 卤4.83) mm, female is less than (11.68 卤4.69) mm, which can accommodate the safe passage of 4.5mm hollow lag screw. Conclusion: the data of acetabular relative safety zone can be obtained by using CT reconstruction before operation, and the individualized scheme can be established to guide the safety during operation, to quickly place the screws through the quadrilateral body, and to save the cost. The results of this study should not be used as reference for patients with hip arthritis or osteonecrosis of the femoral head.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
本文编号：2176637
[Abstract]:Objective: to measure the position of the safe area of acetabular quadrangular body fixed directly by hollow pull screw. Methods: to obtain the data of adult patients who underwent CT scanning of pelvis with sapphire energy spectrum CT from February 2014 to December 2014. A new scan image was reconstructed from the plane parallel to the anterior column and perpendicular to the four sides of the body, 50 males and 50 females. Using 4.5mm hollow pull screw as the standard, the range of safety passage through the screw was obtained in the direction perpendicular to the anterior column of the acetabular and parallel to the inside side of the four sides of the acetabulum. Results: the upper limit of safe area for the 4.5mm hollow lapping screws in the acetabular quadrangular area was (6.45 卤4.83) mm for males, (38.80 卤7.00) mm for acetabular L2, (11.68 卤4.69) mm for females, and (34.73 卤6.06) mm for females. The average L1 value of acetabular in males and females was significantly higher than that in females. There was no significant difference between male and female acetabular average L2 values (P0.05). The average L2 value of adult acetabular safety zone was (36.67 卤6.77) mm. During the operation, the pelvis quadrilateral body was fixed directly by hollow nail after reduction, which was perpendicular to the anterior column of the acetabulum and attached to the medial side of the quadrilateral body. When point B is taken as reference point, it is less than (36.67 卤6.77) mm or when point E is used as reference, male is less than (6.45 卤4.83) mm, female is less than (11.68 卤4.69) mm, which can accommodate the safe passage of 4.5mm hollow lag screw. Conclusion: the data of acetabular relative safety zone can be obtained by using CT reconstruction before operation, and the individualized scheme can be established to guide the safety during operation, to quickly place the screws through the quadrilateral body, and to save the cost. The results of this study should not be used as reference for patients with hip arthritis or osteonecrosis of the femoral head.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
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