骶髂关节多轴锁定接骨板螺钉系统的研制  

DEVELOPMENT OF POLYAXIAL LOCKING PLATE SCREW SYSTEM OF SACROILIAC JOINT

作　　者：范伟杰[1] 谢雪松[1] 周淑平[1] 张永虎[1] 

机构地区：[1]南华大学附属第一医院骨科,湖南衡阳421001

出　　处：《中国修复重建外科杂志》2014年第9期1091-1095,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的研制一种创伤小、并发症少的骶髂关节固定器械。方法在18具成人骨盆标本（男8具，女10具）双侧骼骨和骶骨上测量与锁定接骨板和锁定螺钉设计相关的解剖学指标；根据解剖测量结果设计骶髂关节多轴锁定接骨板螺钉系统，采用医用钛合金制作。在4具成年男性骨盆标本上，通过生物材料试验系统测试0～700N垂直载荷及0～12N·m扭转载荷下，正常骨盆（A组）、骶髂螺钉固定骶髂关节脱位（B组）及骶髂关节多轴锁定接骨板螺钉系统固定骶髂关节脱位（c组）后，骶髂关节位移距离和位移角度。在1具成年男性尸体标本上模拟应用该系统，观察软组织破坏程度，摄骨盆x线片观察锁定接骨板及锁定螺钉位置。结果根据解剖学测量结果成功设计并制各了一套骶髂关节多轴锁定接骨板螺钉系统。生物力学测试结果表明，0～700N垂直载荷下，A组位移距离显著大于B、C组（P〈0．05），B、C组间比较差异无统计学意义（P〉0．05）。0-12N·m扭转载荷下，A组位移角度显著小于B、C组（P〈0．05）；扭转载荷≤6N·m时B组位移角度大于C组，〉6N·m时B组小于C组，但差异均无统计学意义（P〉0．05）。在尸体标本上安装该系统时，软组织破坏少，植钉准确、安全。结论骶髂关节多轴锁定接骨板螺钉系统体积较小，操作时创伤小；多轴向固定，可灵活调整植钉方向，固定牢固，在尸体标本上应用固定效果良好。Objective To develop an instrument for sacroiliac joint fixation with less injury and less complications. Methods Firstly, 18 adult pelvic specimens （8 males and 10 females） were used to measure the anatomical data related to the locking plates and locking screws on the sacrum and ilium, and the polyaxial locking plate screw system of the sacroiliac joint was designed according to the anatomic data. This system was made of medical titanium alloy. Then 4 adult male plevic specimens were harvested and the experiment was divided into 3 groups： group A （normal pelvic）, group B （the dislocated sacroiliac joint fixed with sacroiliac screws）, and group C （the dislocated sacroiliac joint fixed with polyaxial locking plate screw system）. The vertical displacement of sacroiliac joint under the condition of 0-700 N vertical load and the horizontal displacement on angle under the condition of 0-12 N.m torsional load were compared among the 3 groups by using the biological material test system. Finally, the simulated application test was performed on 1 adult male cadaveric specimen to observe soft tissue injury and the position of the locking plate and screw by X-ray films. Results According to the anatomic data of the sacrum and ilium, the polyaxial locking plate screw system of the sacroiliac joint was designed. The biomechanical results showed that the vertical displacement of the sacroiliac joint under the condition of 0-700 N vertical load in group A was significantly bigger than that in group B and group C （P 〈 0.05）, but there was no significant difference between group B and group C （P 〉 0.05）. The horizontal displacement on angle under the condition of 0-12 N.m torsional load in group A was significantly less than that in group B and group C （P 〈 0.05）. The horizontal displacement on angle under the condition of 0-6 N.m torsional load in group B was bigger than that in group C, and the horizontal displacement on angle under the condition of 6-12 N.m torsional load in group B was le

关 键 词：骶髂关节脱位 骶髂关节多轴锁定接骨板螺钉系统 骨盆内固定 

分 类 号：R687.1[医药卫生—骨科学]