应用解剖

髋臼后柱骨折顺行拉力螺钉置钉导向器的研究

  • 徐勇强 ,
  • 林创鑫 ,
  • 王钢 ,
  • 蔡道章 ,
  • 彭赓 ,
  • 赖剑强 ,
  • 季中华
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  • 1. 南方医科大学南方医院,  广州   510515;    2.湖南省人民医院,  长沙   410008;
    3. 南方医科大学第三附属医院,  广州   515000;    4.珠海市人民医院,  珠海   519000
徐勇强(1981-),男,湖南双峰县人,主治医师,博士研究生,主要从事骨科临床解剖学方面的研究,Tel:13469043016,E-mail:regou1023@163.com

收稿日期: 2015-06-16

  网络出版日期: 2016-01-28

基金资助

广东省自然科学基金(10151051501000085)

Clinical anatomic study of the lag screw guide device for the acetabulum posterior column

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  • 1. Department of Orthopedic Trauma,Nanfang Hospital Affiliated to Southern Medical University,Guangzhou 510515, China;  2. Department of Orthopedics, Hunan Provincial People’s Hospital, Changsha 410005, China; 3. Department of Orthopedics,the Third Hospital Affiliated to Southern Medical University,Guangzhou 515000, China; 4. Department of Anesthesiology, Zhuhai Hospital Affiliated to Jinan University, Zhuhai 519000,  China

Received date: 2015-06-16

  Online published: 2016-01-28

摘要

目的 为髋臼后柱拉力螺钉导向器提供解剖学基础。  方法    收集31具半骨盆骨性标本(男性14例,女性17例),在髋臼后柱顺行置入拉力螺钉导针,测量进钉点的位置和进针方向。  结果    进针点与弓状缘的垂直距离女性为(0.96±0.32) cm,男性为(0.92±0.16) cm(P>0.05),进针点与骶髂关节前缘距离,女性为(2.43±0.66) cm,男性为(1.87±0.26) cm(P<0.05)。进钉方向与髂骨内板的后倾角∠θ女性为(59.68±6.28)°,男性为(56.75±3.22)°(P>0.05)、进钉方向与髂骨内板的外倾角∠φ女性为(41.27±2.76)°,男性为(34.31±2.78)°(P<0.05)。  结论    髋臼后柱骨折顺行拉力螺钉进钉点和进钉方向的测量为导向器的设计提供了解剖学基础,有助于提高髋臼后柱骨折顺行拉力螺钉置钉的成功率和准确性,降低手术风险和减轻手术损伤。

本文引用格式

徐勇强 , 林创鑫 , 王钢 , 蔡道章 , 彭赓 , 赖剑强 , 季中华 . 髋臼后柱骨折顺行拉力螺钉置钉导向器的研究[J]. 中国临床解剖学杂志, 2016 , 34(1) : 43 -45 . DOI: 10.13418/j.issn.1001-165x.2016.01.012

Abstract

Objective To measure anatomical parameters of the guide device for antegrade lag screw fixation of the fractures in the posterior column of acetabulum. Methods 17 females and 14 males semi pelvic bony specimens were collected for this clinical anatomic study. After successful implantation of the antegrade lag screw into the posterior column of acetabulum, the screw entry point and entry angle of inclination were separately measured and statistically analyzed. Results The average distance between the entry point and the arcuate margin was (0.96±0.32) cm in female and (0.92±0.16) cm in male (P>0.05), while the distance between the entry point and the sacroiliac joint front was (2.43±0.66) cm in female and (1.87±0.26) cm in male (P<0.05). The average retroversion angulation of screw was (59.68±6.28)°in female and (56.75±3.22)°in male (P>0.05), while the extraversion angulation was (41.27±2.76)°in female and (34.31±2.78)°in male (P<0.05). Conclusions The results of our measurement can contribute to design of guide device for antegrade lag screw, which could improve the success rate and accuracy of the screw implantation in the posterior column of acetabulum, reduce the surgery risk, and minimize operative trauma.

参考文献

[1]  陈鸿奋,王富明,隆腾飞,等. 顺行拉力螺钉固定髋臼后柱骨折进钉的解剖学参数研究[J]. 中华创伤骨科杂志, 2012, 14(2):153-156.
[2]  陈鸿奋. 髋臼后柱顺行拉力螺钉置钉导航系统的研制与应用[D]. 南方医科大学,2012.
[3]  Shahulhameed A, Roberts CS, Pomeroy CL, et al. Mapping the columns of the acetabulum-Implications for percutaneous fixation[J]. Injury, 2010, 41(4):339-342.             

[4]  Starr A J, Reinert C M, Jones AL. Percutaneous fixation of the columns of the acetabulum: a new technique[J]. J Orthop Trauma,1998,12(1):51-58.
[5]  张大保,王钢,孟祥翔,等. 髋臼后柱经皮逆行拉力螺钉固定可行性的数字模型研究[J]. 中国临床解剖学杂志, 2009, 27(3):288-291.
[6]  王庆贤,张英泽,潘进社,等. 髋臼后柱拉力螺钉内固定的应用解剖学[J]. 中国临床解剖学杂志, 2004, 22(6):596-598.
[7]  郑琦,廖胜辉,石仕元,等. 优化髋臼后柱螺钉内固定的计算机辅助设计[J]. 解剖学报, 2008, 39(2):238-242.
[8]  范永盛,尹维刚,史增元,等. 三维重建模型模拟拉力螺钉固定髋臼后柱骨折的研究[J]. 中国临床解剖学杂志, 2013, 31(3):241-245.
[9] Mu WD, Wang XQ, Jia TH, et al. Quantitative anatomic basis of antegrade lag screw placement in posterior column of acetabulum[J]. Arch Orthop Trauma Surg, 2009,129(11):1531-1537.
[10] 王先泉,张凤华,张伟,等. 髋臼后柱拉力螺钉内固定技术的临床解剖研究[J]. 解剖与临床, 2009, 14(6):417-419.
[11] Dienstknecht T, Müller M, Sellei R, et al. Percutaneous screw placement in acetabular posterior column surgery: Gender differences in implant positioning[J]. Injury, 2014, 45(4):715-720.
[12] Dienstknecht T, Muller M, Sellei R, et al. Screw placement in percutaneous acetabular surgery: gender differences of anatomical landmarks in a cadaveric study[J]. Int Orthop, 2013, 37(4):673-679.

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