新型成人肩胛骨解剖型锁定接骨板的设计研究  

Design of a new type of adult scapular anatomic locking plate

作　　者：史会明[1] 胡远军 陈建华[1] 张堃[2] 王飞 赵小龙[1] 任广铁 Shi Huiming;Hu Yuanjun;Chen Jianhua;Zhang Kun;Wang Fei;Zhao Xiaolong;Ren Guangtie(Department of Orthopedics,Hanzhong Central Hospital,Hanzhong 723000,Shaanxi,Chin;Department of Traumatic Orthopedics,Honghui Hospital Xi＇an,Jiaotong University CollegeofMedicine,Xi＇an 710054,Shaanxi,Chin)

机构地区：[1]陕西省汉中市中心医院骨科,723000 [2]西安交通大学医学院附属红会医院创伤骨科,710054

出　　处：《中华创伤骨科杂志》2018年第7期617-622,共6页Chinese Journal of Orthopaedic Trauma

基　　金：陕西省卫生计生科研基金（2016C005）中国专利号：201820117876.8

摘　　要：目的针对肩胛骨主要骨折部位和后路手术的特点，设计一种固定主要骨折块的新型成人肩胛骨解剖型锁定接骨板。方法收集汉中市中心医院骨科2015年1月至2018年1月行CT检查的80例正常成人肩胛骨影像资料，男43例，女37例。计算机建立3D模型，测量肩胛骨主要骨折固定区域的数据：肩胛颈（CD段）、肩胛骨外侧缘（DE段）、肩胛角（EF段）、肩胛冈（HJJ2和HKK2段）、肩胛颈和外侧缘成角（LCDE）、外侧缘和肩胛角成角（∠DEF）、肩胛冈和肩胛体成角（∠HKK2、∠HJJ2），设计符合手术及固定要求的接骨板。结果测得肩胛骨主要骨折固定区域数值，即接骨板各段长度CD、DE、EF、HJ、HK分别为（10．27±0．99）、（73．03±6．27）、（52．03±6．85）、（36．27±2．10）、（41．44±2．58）mm，接骨板各段间折角∠CDE、∠DEF1、∠DER2、∠HJJ2、∠HKK2分别为（128．61°±6．30°）、（167．11°±3．83°）、（173．01°±4．45°）、（133．43°±7．47°）、（123．55°±7．84°），设计符合肩胛骨外侧缘、肩胛颈及肩胛冈远段固定区域形态的“爪”型肩胛骨解剖型锁定接骨板。结论设计的新型成人肩胛骨解剖型锁定接骨板用于固定肩胛骨主要骨折块，为解决复杂肩胛骨骨折的固定问题提供了新的选择，其临床实用性、有效性有待进一步临床研究。Objective To evaluate a new type of adult scapular anatomical locking plate which was designed for fixation of the major fracture fragment based on the characteristics of major fracture location and posterior surgical approach. Methods The Computed Tomography （CT） data of the scapula were col- lected for this study of the 80 normal adults who had undergone CT scanning from January 2015 to January 2018 at Department of Orthopedics, Hanzhong Central Hospital. They were 43 males and 37 females. 3D models of the scapula were reconstructed using the CT data by computer. After scapular neck （CD）, scapular lateral border （DE）, angulus scapulae （EF）, scapular spine （HJJ2 and HKK2）, and angles of the scapula （ L CDE, L DEF, L HKKz and L HJJ2） were measured, our new type of adult scapular anatomical locking plate was designed to meet the requirements of operation and fixation. Results The main parameters of the scapula at the major fixation region were CD of 10. 27± 0. 99 mm, DE of 73.03 ± 6. 27 mm, EF of 52. 03±6. 85 mm, HJ of 36.27±2.10 ram, HK of 41.44 ±2.58 ram, ∠CDE of 128.61°±6. 30°, ∠DEF1 of 167.11°±3.83°, ∠ DEF2 of173. 01° ± 4. 45°, ∠HJJ2of133.43°±7.47°, and ∠HKK2 of123.55°± 7.84°. The new type of claw-shaped scapular locking plate we had designed conformed to the segmental lengths and the angles between the adjacent segments of the scapula. Conclusions Our new type of adult scapular anatomical locking plate may be used to fix the major scapular fracture fragment, providing a new choice to solve the problem in fixation of complex scapular fractures. However, its clinical practicality and effectiveness needs further clinical research.

关 键 词：肩关节 肩胛骨 骨折 解剖型 骨板 

分 类 号：R687.3[医药卫生—骨科学]