骶髂螺钉固定在骶髂关节脱位中的应用解剖学研究  

Applied anatomic study on iliosacral screw fixation for iliosacral joint disruption

作　　者：杨开舜[1] 马梦昆[2] 劳汉昌[2] 

机构地区：[1]大理医学院附属医院骨科,云南大理671000 [2]昆明医学院第二附属医院骨科,昆明650101

出　　处：《中国矫形外科杂志》2004年第11期848-850,共3页Orthopedic Journal of China

摘　　要：目的 :为应用骶髂螺钉固定骶髂关节脱位提供形态学依据。方法 :对 3 0具成人干燥骨盆标本 ,模拟骶髂螺钉内固定手术并作CT扫描 ,对进针点与不同解剖结构之间的距离、进针的方向、进针的深度以及S1骶孔上方的骶骨翼的前后径和上下径进行测量。结果 :进针点距臀肌线的距离为 ( 2 0 70± 3 2 7)mm ,距坐骨大切迹的距离为( 3 5 0 0± 1 91)mm ;轴位及冠状位CT测量进针与髂骨外板的交角分别为 ( 90 18± 2 69)°和 ( 90 40± 2 87)° ;进针深度为 ( 67 77± 3 63 )mm ;S1骶孔上方骶骨翼的前后径和上下径分别为 ( 18 2 6± 2 0 6)mm和 ( 18 74± 1 5 1)mm。结论 :临床应用骶髂螺钉固定需选择恰当的进针点和进针方向 ,术中需行骨盆正位。Objective:To provide the related morphological data for the application of iliosacral screw fixation in iliosacral joint disruption.Method:Iliosacral screw fixation have been taken on 30 dry adult pelvic specimen,then they were studied under direct view and CT scans.The measurement included:the distances from the inserting point of the guidewire to various structures of pelvis,the inserting direction of the guidewire,the length from the inserting point to the center of S 1 body and the distances from the S 1 foramen to the anterior and upper cortex of the sacral ala.Result:The distances from the inserting point to the crista glutea and to the greater sciatic notch were (20.7±3.27)mm and (35.00±1.91)mm;The angles between guidewire and iliac surface in axial CT scans and in coronal CT scans was (90.18±2.69) °and (90.40±2.87)°;The distance from the inserting point to the center of S 1 body was (67.77 +3.63)mm;The distance from the S 1 foramen to the anterior and upper cortex of the sacral alas was (18.26 +2.06)mm and (18.74±1.51)mm.Conclusion:A suitable inserting point and direction shoud be paid a great attention in the clinical application of iliosacral screw fixation.It is also very necessary to take multiple AP as well as caudad and cephalad view under an image intensifier in the operation

关 键 词：骶髂关节 骶髂螺钉固定 解剖学 

分 类 号：R687.3[医药卫生—骨科学]