髋臼后柱壁安全置钉的数字化解剖研究  

Digital anatomic study of the secure placement of screw on posterior column wall of acetabulum

作　　者：郑益钒 陈嘉楠 裴璇 周唯 方志勋 程翼鹏 刘曦明 Zheng Yifan;Chen Jianan;Pei Xuan;Zhou Wei;Fang Zhixun;Cheng Yipeng;Liu Ximing(Department of Orthopedics,General Hospital of Central Command,Wuhan 430070,China;The First School of Clinical Medicine,Southern Medical University,Guangzhou 510515,China;School of Clinical Medicine,Wuhan University of Science and Technology,Wuhan 430070,China)

机构地区：[1]解放军中部战区总医院骨科,武汉430070 [2]南方医科大学第一临床医学院,广州510515 [3]武汉科技大学临床医学院,武汉430070

出　　处：《中国临床解剖学杂志》2024年第2期131-135,共5页Chinese Journal of Clinical Anatomy

基　　金：卫勤保障能力创新与生成专项(20WQ034)。

摘　　要：目的数字化测量髋臼后柱壁安全置钉相关参数,为临床治疗后壁或/和后柱骨折置钉提供参考。方法经软件Mimics20.0重建100例正常成人髋骨三维模型。将髋臼后壁分为累及臼顶的高位后壁区与未累及臼顶的低位后壁区,切割髋臼高位后壁区得到断面M、D、E和N,切割低位髋臼后壁区形成断面F、G、H、I和J。在断面上测量进钉角度和进钉长度。结果在断面M、D、E和N上距臼缘5.0mm的进钉点,男女螺钉最大安全进钉角度分别不应超过80°、70°、60°与50°,男女进钉长度分别不应超过40.0与35.0 mm。在断面F、G、H、I和J上,男女距臼缘5.0、10.0、20.0与30.0 mm的进钉角度应分别小于50°、60°、80°和90°。断面F至J中,男性进钉点螺钉长度应分别小于40.0、35.0、30.0、30.0与40.0 mm;女性应分别小于35.0、30.0、25.0、25.0与35.0 mm。结果在髋臼后柱壁不同进钉位点,应采取不同的进钉角度与长度以防螺钉误入髋关节腔。Objective To digitally measure the relevant anatomical parameters of safe screw placement for posterior column wall of the acetabulum,so as to provide data reference for the clinical treatment of screw placement for posterior wall and/or posterior column fractures.Methods 3D hip-bone models of 100 normal adults were reconstructed by Mimics 20.0.The acetabular posterior wall was divided into high posterior wall area involving the acetabular roof and the low posterior wall area without involving the acetabular roof.Sections M,D,E and N were obtained by cutting the high posterior wall area of the acetabulum,and sections F,G,H,I and J were obtained by cutting the low posterior wall area of the acetabulum.The following parameters were measured on each section:the angle and the length of the screw.Results In the entry points 5.0 mm away from the acetabular edge on sections M,D,E and N,the maximum safe entry angles of screws for men and women should not exceed 80°,70°,60° and 50°,respectively,and the entry lengths for men and women should not exceed 40.0mm and 35.0mm,respectively.On sections F,G,H,I and J,the screw angles of 5.0 mm,10.0 mm,20.0 mm and 30.0 mm away from the acetabular edge should be less than 50°,60°,80° and 90°,respectively.On sections F to J,the screw lengths of male should be less than40.0 mm,35.0 mm,30.0 mm,30.0 mm and 40.0 mm,respectively,the screw lengths of female should be under 35.0 mm,30.0 mm,25.0 mm,25.0 mm and 35.0 mm respectively.Conclusions Different insertion angles and lengths should be adopted at different insertion points in the posterior column wall of the acetabulum to avoid the screw entering into the hip cavity.

关 键 词：髋臼 后柱 后壁 数字化 解剖测量 

分 类 号：R323.45[医药卫生—人体解剖和组织胚胎学]