自制三维解剖锁定钢板固定复合型髋臼骨折的解剖学研究  

Anatomical study on the treatment of complex acetabular fractures with self-disigned 3-dimensional anatoimical locking plate

作　　者：王辉 毕大卫 胡钢锋 祖罡 韩雷 

机构地区：[1]萧山区第一人民医院骨科,浙江杭州311211 [2]萧山中医院,浙江杭州311201

出　　处：《中国骨伤》2013年第2期149-152,共4页China Journal of Orthopaedics and Traumatology

基　　金：浙江省医药科技卫生项目(编号:2011KYB091)~~

摘　　要：目的:根据髋臼解剖特点,研制一种三维解剖锁定钢板固定除后壁及后柱的复合型髋臼骨折,尤其是包括四方区移位的复合型髋臼骨折,并探讨其优缺点。方法:通过对40具成人骨盆及5具成人新鲜尸体标本的测量、试验,测量弓状线弓耻线弧长和弧度、髋臼中心至弓状线的距离等解剖数据,设计出三维解剖锁定钢板,经髂腹股沟入路或者联合Stoppa入路固定复合型髋臼骨折。结果:弓状线弧长:男(54.12±5.42)mm,女(58.24±6.60)mm。弧度:男(64.26±10.28)°,女(60.32±12.26)°。弓耻弧长:男(122.21±8.02)mm,女(126.52±7.84)mm。弓耻弧度:男(66.24±13.10)°,女(63.25±12.10)°。髋臼中心至弓状线的距离:男(18.6±2.2)mm,女(18.9±2.5)mm。由髂腹股沟入路或者联合Stoppa入路对非后壁及后柱的复合型髋臼骨折,包括四方区移位的髋臼骨折施行三维解剖锁定钢板内固定,复位及固定可靠。结论:采用自制三维解剖锁定钢板固定非后壁及后柱的复合型髋臼骨折能解决既往常规内固定难以解决的一些复合型髋臼骨折,复位固定更加精准、可靠、稳定,且手术创伤小,开拓髋臼骨折内固定的新思路。Objective：To design a new 3-dimensional anatomical locking plate internal fixation on the basis of anatomic character of acetabulum for treating complex acetabular fractures except the posterior wall and posterior column fracture, and to investigate its advantages, and disadvantages. Methods：Five fresh adult cadavers and 40 biopsy specimens of pelvic cavity were collected. The length and radian of iliopectineal crest and pecten pubis, the distance from acetabular index to iliopectineal crest were measured to guide the research and development of the 3-dimensional anatomical locking plate internal fixation for complex acetabular fractures through the ilioinguinal approach or combined with Stoppa approach. Results：The average lengths of iliopectineal crest of male and female were （54.12±5.42） mm and （58.24±6.60） mm;and the radians were（64.26± 10.28 ） ° and （ 60.32± 12.26 ） °. The lengths of bow pubic were （ 122.21 ±8.02 ） mm and （ 126.52＋7.84 ） mm ; and the radians were （66.24±13.10）° and（63.25±12.10）°. The distance from acetabular index to iliopectineal crest of male and female were （18.6 ±2.2 ） mm and （ 18.9± 2.5 ） mm. The 3-dimensional anatomical locking plate was used to treat compound acetabular fractures through ilio-inguinal groove incision or combined with Stoppa incision, including dislocated acetabular fractures at quadratic district,but not including paries posterior and columma posterior fractures. Conclusion：The self-designed 3- dimensional anatomical locking plate internal fixation has the characteristics of operational convenience, accurate fixation, mini operational trauma, short operational time and low operational risk, therefore it is especially suit for the complex acetabular fractures except the posterior wall and posterior column fracture which is difficult to be solved by contentional internal fixation.

关 键 词：髋臼 骨折固定术 内 解剖学 

分 类 号：R473.6[医药卫生—护理学]