一种新式骨盆及髋臼通道螺钉的置钉方法  

A new method of trajectory screw placement for pelvis and acetabulum

作　　者：田吉光 王志勇[1] 程林[1] 桑锡光[1] TIAN Jiguang;WANG Zhiyong;CHENG Lin;SANG Xiguang(Department of Emergency Surgery&Traumatic Orthopaedics,Qilu Hospital of Shandong University,Jinan 250012,Shandong,China)

机构地区：[1]山东大学齐鲁医院急诊外科/创伤骨科,山东济南250012

出　　处：《山东大学学报（医学版）》2022年第10期17-26,共10页Journal of Shandong University:Health Sciences

基　　金：山东省技术创新引导计划(2019YFF0302303)

摘　　要：目的设计一种新式骨盆及髋臼通道螺钉的置钉方法,根据该方法设计相应装置并进行人体标本研究,以判断该方法的置钉效果。方法本研究以CT影像数据为基础,利用投影原理和方向分解的方法,准确定位钉道入钉点及入钉方向,并根据以上理论设计制作了一套专用定位架。术前将定位架固定到人体骨盆标本上并进行CT扫描以获得数据,利用CT分析软件规划钉道,再通过方向分解的方法测得所需定位参数,术中在定位架上做出相应的调整,即可准确定位钉道。结果利用上述方法,成功进行骶髂螺钉、LCⅡ螺钉、顺行前柱螺钉的置入。CT重建结果显示,术后钉道位置与术前规划位置高度一致,术后X线检查显示结果符合临床要求。结论本方法可准确定位骨盆及髋臼通道螺钉的空间位置,极大提高了手术的准确性。本方法原理简单,易于学习和操作,且价格低廉,易于在广大基层医院中普及,为骨盆及髋臼的微创治疗提供新的有效手段。Objective To develop a new method of percutaneous screw fixation for pelvis and acetabulum.Based on this method,a device was designed and human specimens were studied to evaluate the efficacy of screw fixation.Methods Based on CT data,this study adopted projection and direction decomposition to accurately locate the screw entry point and entry direction,and designed a set of special location frame.Before surgery,the location frame was fixed to the human specimen pelvis and CT scan was performed to obtain data.The screw path was planned using CT analysis software,and then the required positioning parameters were measured with direction decomposition.Then the screw path was located with the help of the location frame during operation.Results The sacroiliac,LCⅡand anterograde anterior column screws were successfully inserted by the above method.CT scanning showed postoperative screw paths were highly consistent to the preoperative designed ones,and met the clinical criteria well.Conclusion This new method provides an accurate,convenient,rapid and cost-effective way for pelvis and acetabulum percutaneous screw fixation,and is recommended for clinic application.

关 键 词：方向分解 投影 通道螺钉 骨盆骨折 髋臼骨折 

分 类 号：R687.3[医药卫生—骨科学]