摘要
目的研究改良Stoppa入路拉力螺钉经前柱固定髋臼后柱、后壁的解剖通路。方法收集30例正常成人半骨盆CT数据并重建骨盆髋臼模型,在改良Stoppa入路可见范围内模拟螺钉由髋臼前柱向后柱、后壁置入。测量参数:入钉点与髋臼顶点距离(H1),入钉点与真骨盆内缘的距离(H2),由入钉点向髋臼后壁下部置入螺钉的长度(L1),由入钉点垂直真骨盆面向髋臼后壁中部置入螺钉的长度(L2),由入钉点向髋臼后壁上部置入螺钉的长度(L3),由入钉点向髋臼后柱坐骨小切迹部置入螺钉的长度(L4);髋臼下部螺钉与髋臼后壁中部置钉夹角(A1),髋臼上部螺钉与髋臼后壁中部置钉夹角(A2),髋臼后柱坐骨小切迹螺钉与髋臼后壁中部螺钉夹角(A3),髋臼后柱坐骨小切迹螺钉与进钉点和骶髂关节前缘与真骨盆内缘交点连线的夹角为(A4),髋臼后柱坐骨小切迹螺钉与髂骨翼平面夹角为(A5)。结果男性组模拟置钉后L1、L2、L3、L4明显大于女性组,差异有统计学意义(P <0.05);但2组H1、H2、A1、A2、A3、A4、A5比较差异无统计学意义(P>0.05)。4例3D打印模型(2例男性髋臼及2例女性髋臼)经自制导向器置钉后验证成功。结论在改良Stoppa入路可显露的骨盆范围内,由髋臼前柱固定髋臼后柱、后壁的螺钉安全通路存在,并且经3D打印模型置钉验证成功。
Objective To study the anatomical pathway through the modified Stoppa approach for anterior column screw fixation into the posterior column and the posterior wall of acetabulum. Methods The CT data of 30 normal adults were collected and the pelvic acetabular model was reconstructed. The simulated screw was placed from the anterior column to the posterior column and the posterior wall of acetabulum within the visible range of the modified Stoppa approach. The following parameters were measured: the nail and acetabulum point distance(H1), into the pin point and true the distance around the pelvis(H2), from the nail into the point to the wall after acetabulum bottom in the length of the screw(L1), by a nail into the central point of vertical wall after pelvic acetabulum oriented really put the length of the screw(L2), by the pin point to the wall after acetabulum placement in the length of the screw(L3), from the nail into the point to the acetabulum after small column sciatic notch department in the length of the screw(L4);Acetabulum bottom screw and middle wall after acetabulum nailing angle(A1), upper acetabulum screw and middle wall after acetabulum nailing angle(A2), small column sciatic notch after acetabulum screw and middle wall after acetabulum screw angle(A3), small column sciatic notch after acetabulum screw and nail into point and sacroiliac joint front and true pelvis around the intersection angle of attachment for(A4), small column sciatic notch after acetabulum screws and iliac wing plane angle(A5). Results In the male group, L1, L2, L3 and L4 were significantly higher than those in the female group, and the differences were statistically significant( P <0.05). However,differences in group H1, H2, A1, A2, A3, A4 and A5 were not statistically significant(P >0.05). Four 3D printing models(2 male and 2 female acetabular) were successfully verified after screw placement with a self-made guide device. Conclusion Within the exposed pelvic area of the modified Stoppa approach, there is a screw safety access
作者
梅亮
张堃
付亚辉
王虎
姜永宏
MEI Liang;ZHANG Kun;FU Ya-hui;WANG Hu;JIANG Yong-hong(Department of Orthopedics,Honghui Hospital,Xi'an Medical College,Xi'an,Shaanxi 710054,China)
出处
《中国骨与关节损伤杂志》
2018年第12期1233-1235,共3页
Chinese Journal of Bone and Joint Injury
基金
陕西省重点研发计划项目(2017SF-011)
