CAJ | 학술논문

目的探讨顺行拉力螺钉固定髋臼后柱骨折的进钉参数,为进钉瞄准器的研制提供应用解剖学基础.方法收集40例正常成人(男20例,女20例)骨盆的螺旋CT扫描数据,重建骨盆三维模型.经髂前上棘(A)和髂后上棘(B)的骨性最突出点的连线中点M做一平面(γ)垂直于AB,在髋臼后柱的γ截面上模拟置人虚拟圆柱体,该圆柱体从髂翼内侧的穿出点(O)即为拉力螺钉的入钉点.在弓状缘上取点D,使OD成为入钉点与弓状缘之间的最短距离,连结OD,G点为骶髂关节最前缘,连结DG.测量OD、DG的距离、置入拉力螺钉的长度、拉力螺钉与冠状面的夹角(α)及与矢状面的夹角(β). 结果 OD距离平均为(13.62±2.19)mm,DG距离平均为(15.27±4.01) mm,能置入拉力螺钉的长度平均为(116.65±7.19) mm,α夹角平均为15.47°±4.01°,β夹角平均为6.65°±2.93°.男、女性在DG距离、β夹角、置入拉力螺钉的长度方面差异均有统计学意义(P＜0.05),而在OD距离及α夹角方面差异均无统计学意义(P＞0.05). 结论根据髋臼后柱顺行拉力螺钉置钉的解剖学参数,术中置入合适长度的拉力螺钉是可行的,可作为研发进钉瞄准器的应用解剖学依据.
목적 탐토순행랍력라정고정관구후주골절적진정삼수,위진정묘준기적연제제공응용해부학기출.방법 수집40례정상성인(남20례,녀20례)골분적라선CT소묘수거,중건골분삼유모형.경가전상극(A)화가후상극(B)적골성최돌출점적련선중점M주일평면(γ)수직우AB,재관구후주적γ절면상모의치인허의원주체,해원주체종가익내측적천출점(O)즉위랍력라정적입정점.재궁상연상취점D,사OD성위입정점여궁상연지간적최단거리,련결OD,G점위저가관절최전연,련결DG.측량OD、DG적거리、치입랍력라정적장도、랍력라정여관상면적협각(α)급여시상면적협각(β). 결과 OD거리평균위(13.62±2.19)mm,DG거리평균위(15.27±4.01) mm,능치입랍력라정적장도평균위(116.65±7.19) mm,α협각평균위15.47°±4.01°,β협각평균위6.65°±2.93°.남、녀성재DG거리、β협각、치입랍력라정적장도방면차이균유통계학의의(P＜0.05),이재OD거리급α협각방면차이균무통계학의의(P＞0.05). 결론 근거관구후주순행랍력라정치정적해부학삼수,술중치입합괄장도적랍력라정시가행적,가작위연발진정묘준기적응용해부학의거.
Objective To provide evidence of applied anatomy for development of a targeting device for antegrade lag screw fixation in the treatment of fractures of the acetabular posterior column. Methods Virtual three-dimensional pelvic models were reconstructed from computed tomography (CT) scans of the pelvis obtained from 40 adult subjects without any bony problem (20 males and 20 females).The most prominent bony points on the anterior supetior iliac spine (ASIS) and posterior superior iliac spine (PSIS) were identified and respectively marked as A and B.Next,a plane (γ) that was perpendicular to the section AB was made to pass through the midpoint (M) of section AB.Virtual cylindrical implants were placed into the postetior column of the acetabulum.The projection point (O) of the antegrade lag screw on the inner table was thus defined.Next a line designated as OD was drawn perpendicularly from the point O to the linea terminalis at the point D.Another line,designated as DG,was drawn from the point D to the anterior border of the auricular surface (G).The lengths of OD and DG were measured.The length of the screw,Angle α between the cylindrical and the coronal planes and Angle β between the cylindrical and the sagittal planes were also measured. Results The average lengths of OD and DG were 13.62 ± 2.19 mm and 15.27 ± 4.01 mm,respcctively.The average length of the lag screw was 116.65 ± 7.19 mm,Angle αwas 15.47 ° ± 4.01° and Angle β was 6.65 ° ± 2.93 °.There were significant differences between males and females in DG length,lag screw length,and Angle β ( P ＜ 0.05).Conclusions An adequate length of the antegrade lag screw can be placed in the posterior column of the acetabulum.This study also provides evidence of applied anatomy for development of a targeting device for antegrade lag screw fixation in the treatment of fractures of the acetabular posterior column.