骨盆骨折侧方挤压Ⅱ型螺钉导针入针点的定位及解剖学测量  

Localization and anatomical measurement of lateral compressionⅡscrew guide needle insertion point for pelvic fracture

作　　者：陈永正 胡振华 李少娟 梁夏存 侯力康 朱树亮 白昕颖 何金键 杨德猛[3] 陈志国 CHEN Yong-zheng;HU Zhen-hua;LI Shao-juan;LIANG Xia-cun;HOU Li-kang;ZHU Shu-liang;BAI Xin-ying;HE Jin-jian;YANG De-meng;CHEN Zhi-guo(Imaging Department,Pingdingshan Traditional Chinese Medicine Hospital,He’nan Pingdingshan 467000,China;The First Clinical College,Xinxiang Medical University,He’nan Xinxiang 453000,China;Department of Orthopaedics,Jiangxi Pingxiang People’s Hospital,Jiangxi Pingxiang 337000,China)

机构地区：[1]平顶山市中医医院影像科,河南平顶山467000 [2]新乡医学院第一临床学院,河南新乡453000 [3]江西萍乡市人民医院创伤骨科,江西萍乡337000

出　　处：《解剖学报》2024年第6期728-733,共6页Acta Anatomica Sinica

基　　金：江西省卫生健康委计划(SKJP202212188)。

摘　　要：目的测量骨盆骨折侧方挤压Ⅱ型(LC-Ⅱ)螺钉导针入针点与髂前下棘周围重要结构距离,同时对入针点进行定位研究,为临床置钉提供解剖学参考。方法对40例防腐成年大体标本,在C臂机监视下,进行LC-Ⅱ螺钉导针置入,解剖标本,测量入针点与股外侧皮神经、股神经、股动脉、股静脉、髂前上棘和腹股沟韧带的最短距离。入针点、髂前上棘和腹股沟韧带构建直角三角形,计算得出入针点准确位置。结果男性入针点与股静脉的平均距离(50.67±7.29)mm>髂前上棘(43.83±7.58)mm>股动脉(38.35±6.63)mm>股神经(31.17±1.67)mm=腹股沟韧带(28.69±6.59)mm>股外侧皮神经(7.98±3.81)mm。女性入针点与髂前上棘的平均距离(45.28±7.07)mm=股静脉(43.72±6.89)mm>股动脉(33.76±6.33)mm>股神经(25.66±6.46)mm=腹股沟韧带(23.22±5.00)mm>股外侧皮神经(8.97±4.76)mm。男性入针点的投影距离为31.77 mm,女性为38.41 mm。男性∠b为42.81°,女性为31.71°。结论LC-Ⅱ螺钉置入最易损伤股外侧皮神经,损伤风险与性别无关。入针点定位方法a和b,可使LC-Ⅱ螺钉迅速安全准确置入,减少透视时间与次数。Objective To measure the distance between the lateral compressionⅡ(LC⁃Ⅱ)screw guide needle and the surrounding important structures around the anterior inferior iliac spine in pelvic fractures and to locate the needle point,so as to provide anatomical reference for clinical nail placement.Methods Totally 40 adult gross specimens of embalming were implanted with LC⁃Ⅱscrew guide needle under the surveillance of C⁃arm machine,and the specimens were dissected.The shortest distance between the insertion point and the lateral femoral cutaneous nerve,femoral nerve,femoral artery,femoral vein,anterior superior iliac spine and inguinal ligament was measured.The triangle was constructed between the insertion point,anterior superior iliac spine and inguinal ligament,and the exact location of the entry point was calculated.Results The average distance between the insertion point of the male needle and the femoral vein was(50.67±7.29)mm>the anterior superior iliac spine(43.83±7.58)mm>the femoral artery(38.35±6.63)mm>the femoral nerve(31.17±1.67)mm=the inguinal ligament(28.69±6.59)mm>the lateral femoral cutaneous nerve(7.98±3.81)mm.The mean distance between the insertion point of the female needle and the anterior superior iliac spine was(45.28±7.07)mm=femoral vein(43.72±6.89)mm>femoral artery(33.76±6.33)mm>femoral nerve(25.66±6.46)mm=inguinal ligament(23.22±5.00)mm>lateral femoral cutaneous nerve(8.97±4.76)mm.The projection distance of the entry point was 31.77 mm for men and 38.41 mm for women.The Angle b was 42.81°for men and 31.71°for women.Conclusion The lateral femoral cutaneous nerve is most vulnerable to injury when LC⁃Ⅱscrew is inserted,and the risk of injury has nothing to do with sex.The insertion point positioning method a and b made LC⁃Ⅱscrew placement quickly,safely and accurately,and reduced fluoroscopy time and frequency.

关 键 词：侧方挤压Ⅱ型螺钉 入针点 定位研究 解剖学测量 人 

分 类 号：R323.5[医药卫生—人体解剖和组织胚胎学]