经皮逆行耻骨上支最大螺钉通道的数字解剖学研究  

Digital anatomical research on the maximum screw channel of the percutaneous retrograde suprapubicbranch

作　　者：杨德猛[1] 何金键 张铭坤 宋金行 李少娟 任天宁 闫含笑 胡振华[2] 彭丹丹 朱树亮 侯力康 韩木愚 陈志国[3] Yang Demeng;He Jinjian;Zhang Mingkun;Song Jinhang;Li Shaojuan;Ren Tianning;Yan Hanxiao;Hu Zhenhua;Peng Dandan;Zhu Shuliang;Hou Likang;Han Muyu;Chen Zhiguo(Trauma Center,Pingxiang People's Hospital,Pingxiang 337000,China;Xinxiang Medical University,Xinxiang 453000,China;Basic Medical College,Xinxiang Medical University,Xinxiang 453000,China)

机构地区：[1]萍乡市人民医院创伤中心,江西萍乡337000 [2]新乡医学院,河南新乡453000 [3]新乡医学院基础医学院,河南新乡453000

出　　处：《中国临床解剖学杂志》2024年第6期644-648,共5页Chinese Journal of Clinical Anatomy

基　　金：江西省卫生健康委计划(SKJP202212188)。

摘　　要：目的建立骨盆3D模型,模拟耻骨上支螺钉置入过程,确定逆行耻骨上支螺钉置入最大通道的参数。方法收集萍乡市人民医院影像中心2020年12月~2023年1月成年人骨盆CT扫描数据50例,导入Mimics 20.0软件,重建骨盆3D模型并模拟螺钉置入。置入流程如下:(1)确定耻骨上支螺钉通道的轴线,置入小直径虚拟圆柱;(2)增加虚拟圆柱的直径,直至其恰不突破耻骨体、耻骨上支及髋臼为止,视其为最大螺钉通道;(3)测量最大螺钉通道的长度、直径,螺钉轴线与矢状面和横断面的角度。结果最大通道长度范围:男性右侧(107.26±7.58)mm、男性左侧(106.96±11.01)mm、女性右侧(102.34±8.30)mm、女性左侧(103.30±10.05)mm;最大通道直径范围:男性右侧(8.10±0.61)mm、男性左侧(8.05±0.66)mm、女性右侧(6.57±0.77)mm、女性左侧(6.48±0.61)螺钉通道最大长度和与横断面夹角在性别和左右侧别间差异无统计学意义(P>0.05);最大直径在左右侧别间差异无统计学意义(P>0.05)。在男女性别间差异有统计学意义(P<0.001)。结论男性最大螺钉通道的平均直径为8.07 mm,平均长度107.11 mm;女性平均为6.50 mm,平均长度为102.82 mm。本研究可为经皮逆行耻骨上支通道螺钉固定耻骨上支骨折提供解剖学参考。Objective To construct a 3D model of the pelvis,simulate the process of suprapubic screw placement,and determine the parameters of the largest channel for retrograde suprapubic screw placement.Methods Pelvic CT scan data of 50 adults were collected from the Imaging Center of Pingxiang People's Hospital from December 2020 to December 2022.This data was imported into Mimics 20.0 software to reconstruct the 3D pelvic model and simulate screw placement.The placement process was as follows:(1)The axis of the suprapubic screw channel was determined,a small-diameter virtual cylinder was inserted;(2)The diameter of the virtual cylinder was increased until it didn't break through the pubic body,suprapubic ramus and acetabulum,considering it as the largest screw channel;(3)The length and diameter of the largest screw channel,the angle of the screw axis with the sagittal and transverse planes were measured.Results The ranges of the largest channel length were:male right(107.26±7.58)mm,male left(106.96±11.01)mm,female right(102.34±8.30)mm,female left(103.30±10.05)mm;the range of largest channel diameter were:male right(8.10±0.61)mm,male left(8.05±0.66)mm,female right(6.57±0.77)mm,female left(6.48±0.61)mm.There was no significant difference in the maximum length of the screw channel and the included angle with the cross section between male and female and between the left and right sides(P>0.05).There was no significant difference in the maximum diameter between the left and right sides(P>0.05),but the difference between male and female was statistically significant(P<0.001).Conclusions The average diameter and length of male in maximum screw channel are 8.07 mm and 107.11 mm,respectively.The average diameter and length of female are 6.50 mm 102.82 mm,respectively.This study can provide anatomical reference for percutaneous retrograde suprapubic branch screw fixation and help clinicians choose suitable surgical screws.

关 键 词：耻骨上支骨折 逆行耻骨上支螺钉 数字解剖 

分 类 号：R323.45[医药卫生—人体解剖和组织胚胎学]