数字化测量正常成人男女性髋臼前柱解剖学参数的临床意义  

Clinical significance of anatomic parameters of acetabular anterior column of normal male and female adults by digital measurement

作　　者：王剑[1] 云文科[1] 李格当[1] 蔡永强 张少杰 恩和吉日嘎拉 王星 王威 王海燕 高尚 王建中 王志强 高明杰 马界荣 李筱贺 Wang Jian;Yun Wen-ke;Li Ge-dang;Cai Yong-qiang;Zhang Shao-jie;Enhejirigala;Wang Xing;Wang Wei;Wang Hai-yan;Gao Shang;Wang Jian-zhong;Wang Zhi-qiang;Gao Ming-jie;Ma Jie-rong;Li Xiao-he(Second Department of Surgery,Armed Police Corps Hospital of Inner Mongolia,Hohhot 010050,Inner Mongolia Autonomous Region,China;Department of Human Anatomy,School of Basic Medicine,Inner Mongolia Medical University,Hohhot 010110,Inner Mongolia Autonomous Region,China)

机构地区：[1]武警内蒙古总队医院外二科,内蒙古自治区呼和浩特市010050 [2]内蒙古医科大学基础医学院人体解剖教研室,内蒙古自治区呼和浩特市010110

出　　处：《中国组织工程研究》2018年第11期1713-1718,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81460330);内蒙古自然科学基金(2016ms08131);内蒙古教育厅科技英才(NJYT-15-B05);内蒙古科技计划项目(2016);内蒙古财政厅科技引导项目(2017);内蒙古人社厅归国留学人员基金(201620)~~

摘　　要：背景:髋臼前柱外形复杂,周围有股动脉、股神经等重要结构,固定螺钉进入髋臼内亦时有发生,目前关于骨盆髋臼前柱骨折钢板内固定技术的定量解剖学资料较少。目的:通过数字化三维重建与测量分析正常成人髋臼前柱切面的数字解剖特点,比较男女骨盆的性别差异。方法:对30例(男女各半)正常成人骨盆行CT扫描,获取数据,利用Materialise Mimics Innovation Suite 16.0软件测量以骨盆界线为参考线切片,以闭孔沟、髂耻隆起、髂前下棘、髂前上棘为参考标志,将男、女各15例(30侧)髋臼前柱自闭孔沟到髂前上棘段对应界线以5 mm为层厚进行切片,切线与界线垂直,切面与前柱上面垂直,测量各切面距离界线5,10,15 mm点到髋臼的切线角度及长度,以及髋臼前后缘到髂前下棘、髂耻隆起和耻骨结节的垂直距离。结果与结论:(1)髋臼前柱从闭孔沟到髂前上棘切面,侧别间比较差异无显著性意义(P>0.05);(2)不论男、女,第5层切面的切线角度最小,第6层切面的切线长度最长;男、女性别比较除第2层切面5 mm点长度和角度差异无显著性意义外,其余差异均有显著性意义(P<0.05),女性大于男性;(3)结果提示:a.不同骨折范围,不同固定钢板位置,其置钉角度和螺钉长度都是动态变化的,因此只能按照以上的区间范围选定,而不能固定到一定数值,最准确有效的设计置钉角度和长度应该针对每个患者设计个体化的置钉参数;b.运用Mimics软件可对成人髋臼前柱骨折的CT数据进行三维重建,并可测出多项指标,为髋臼前柱骨折的临床诊治提供理论参考。BACKGROUND:Acetabulum anterior column shape is complex,and closed to femoral artery,and femoral nerve.Fixed screws easily went into the acetabulum.Currently,there was less data on quantitative anatomy data of pelvic acetabulum fracture with anterior column plate internal fixation.OBJECTIVE:To compare the pelvis gender differences by analyzing digital anatomical features of normal adult acetabulum anterior column section through digital three-dimensional reconstruction and measurement.METHODS:Totally 30 normal adults(half male and half female)received pelvic CT scans,and data were obtained.Using Materialise Mimics Innovation Suite 16.0 software,the boundary of the pelvis was used as reference line for sectioning.The obturator groove,iliopubic eminence,anterior inferior iliac spine,and the anterior superior iliac spine were used as a reference mark.In 15 males and 15 females(30 sides),the corresponding boundary line from obturator groove to the anterior superior iliac spine of acetabular anterior column was sliced into 5 mm-thick sections.The tangent line was vertical to the boundary line.The tangent plane was vertical to the upper plane of the anterior column.The angle and length of each section 5,10,15 mm points from the boundary line to the acetabulum,and the perpendicular distance from anterior and posterior edges of the acetabulum to anterior inferior iliac spine,iliopubic eminence and the pubic tubercle.RESULTS AND CONCLUSION:(1)Acetabular anterior column from the obturator groove to the anterior superior iliac spine section was not significantly different(P>0.05).(2)No matter in males or females,the tangent angle of the fifth layer section was minimum,and the tangent length of the sixth layer section was longest.The length and angle of the second slice at 5 mm point were not significantly different between males and females.However,above indexes in others were significantly larger in females than in males(P<0.05).(3)Results indicated that in different fracture ranges and different fixation plate positions,th

关 键 词：骨科植入物 髋臼前柱 数字解剖 测量 临床应用 国家自然科学基金 髋臼 解剖 组织工程 

分 类 号：R318[医药卫生—生物医学工程]