拉力螺钉固定髋臼后柱骨折的数字化测量  

Digital measurement on transiliac anterograde lag screw for fixation of acetabular posterior column fractures

作　　者：师博 冯卫[2] 薛飞[2] SHI Bo;FENG Wei;XUE Fei(Department of Orthopaedics,People's Hospital of Shanxi Province,Taiyuan 030032,China;Department of Traumatic Orthopaedics,The Second Affiliated Hospital,Inner Mongolia Medical University,Hohhot 010030,China)

机构地区：[1]山西省人民医院骨科,太原030032 [2]内蒙古医科大学第二附属医院创伤三科,呼和浩特010030

出　　处：《中国矫形外科杂志》2020年第14期1302-1306,共5页Orthopedic Journal of China

基　　金：内蒙古自治区自然科学基金项目(编号:2017MS0836)。

摘　　要：[目的]通过数字化寻找经髂骨顺行拉力螺钉最佳位置,以期获得一种新的拉力螺钉固定髋臼后柱骨折的手术方法。[方法]选取40例成年人患者,男20例,女20例,年龄18~60岁,平均(42.51±9.16)岁,进行骨盆螺旋CT扫描,将原始Dicom格式数据导入Mimics 17.0中构建三维模型,在Geomagic Studio软件中模拟置入髋臼后柱拉力螺钉,在Solidworks软件中进行拉力螺钉最优钉道的确定及相关参数的测量,进行统计学分析。[结果]男性的拉力螺钉长度和直径均显著大于女性(P<0.05)。但是左、右两侧间在拉力螺钉的长度和直径的差异均无统计学意义(P>0.05)。男性进针点至髂前上棘的距离、进针点至髂后上棘的距离和冠状面夹角均大于女性,但差异均无统计学意义(P>0.05),但是,男性的矢状面夹角显著大于女性(P<0.05)。左右两侧间在上述指标的差异均无统计学意义(P>0.05)。[结论]获得了经髂骨顺行拉力螺钉固定髋臼后柱最佳位置的相关解剖学参数,可为经皮顺行拉力螺钉固定髋臼后柱骨折提供一种新的、安全的手术方式。[Objective]To explore the best position of transiliac anterograde lag screw for fixation of acetabular posterior column fractures by measurement on virtual reality models in order to provide basis of a novel internal fixation technique in clinical setting.[Methods]A total of 40 adult patients,including 20 males and 20 females aged from 18 to 60 years old with an average age of 42.5 years,were enrolled into this study,and underwent spiral CT scan of the pelvis.The original data in Dicom format was processed by Mimics 17.0 software to construct the 3D digital models.After that,placements of transiliac anterograde lag screw for fixation of acetabular posterior column fractures were mimicked on the 3D models to the best position by using Geomagic Studio,and measured by using Solidworks software.[Results]The males had significantly greater length and diameter of the lag screw than the females(P<0.05),despite of no statistically significant differences between the left and right sides in the length and diameter(P>0.05).In addition,the males had greater distances between the insertion point and the anterior superior iliac spine,and posterior superior iliac spine,as well as greater insertion angle in coronal plane than the females,whereas which were of no statistical significance(P>0.05).However,the males had significantly greater insertion angle on the sagittal plane than the females(P<0.05).There were no statistically significant differences in aforesaid items between the left and right sides(P>0.05).[Conclusion]The best position of transiliac anterograde lag screw for fixation of acetabular posterior column fractures is obtained by using the virtual reality 3D models,which might provide a novel fixation technique for posterior acetabular column fracture fixation with anterograde lag screw.

关 键 词：髋臼骨折 三维成像 虚拟现实 拉力螺钉 

分 类 号：R683.3[医药卫生—骨科学]