前路钢板治疗骨盆后环损伤安全置钉的解剖学研究  

Safe Position of Plating Technique for Treating Injury of Posterior Pelvic Ring Through Anterior Approach

作　　者：王愉思[1] 徐勇强[1] 刘喜平[1] 陈润新[1] 魏磊平[1] 阎戈[1] 康亦锋[1] 

机构地区：[1]湖南省人民医院创伤骨科,长沙市410005

出　　处：《中国骨与关节损伤杂志》2011年第10期868-870,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的研究前路钢板治疗骨盆后环损伤的安全置钉位置。方法 15具标本经测量并比较L4、5神经根前支外缘至骶髂关节的上缘、中点、下缘三点距离后,找出离神经根较远的位置。结果 L4、5神经根前支外缘至骶髂关节的距离,上缘与中点的比较无统计学差异,而下缘与其他两点的比较有统计学差异(P<0.05)。结论骶髂关节骨折脱位前路钢板固定时L5神经根较L4神经根受损伤的可能性更大,前路钢板内固定治疗骶髂关节骨折脱位时骶骨翼侧的剥离不应超过骶髂关节内侧20 mm,安全放置钢板及骶骨翼侧螺钉固定的最佳固定位置范围位于骶骨翼中上区域。Objective To study the safe position of plating technique for treating the injury of posterior pelvic ring through the anterior approach. Methods Fifteen cadaver bodies were carefully measured with the distance ranging from the lateral side of the anterior root of L4、5 to the superior, middle and inferior point of iliosacral joint, and the distance relatively far enough for the screws was determined. Resuits There was no difference between the distance measured from the superior and middle point, ranging from the lateral side of L4、5 nerve root to the iliosacral joint （P 〈0.05）. Conclusion The L5 nerve root is more susceptible to injury than the L4 nerve root when the Q fracture-dislocation of sacroiliac joint is fixed with anterior plate. The soft tissue of the ala sacralis should not be dissected beyond the bounds of sacroiliac joint 20 mm inside. The safe location to place the plate and the best fixed position of sacral screw on the ala sacralis is located on the upper and middle ale sacralis.

关 键 词：骨盆后环损伤 前路钢板 安全置钉 

分 类 号：R687[医药卫生—骨科学]