CAJ | 학술논문

目的通过成人尸体髂骨形态解剖学及影像学相关数据的测量与分析,探讨Galveston 固定中最理想的髂骨钉置入路径.方法保存完好的5具10侧新鲜尸体半骨盆,性别不限.于髂骨Chiotic线上方15 mm处每5 mm平行于该线截骨,直至髋臼上缘.分别测量截骨面髂骨钉置入有效路径长度、峡部位置及内径宽度.50例成人患者(性别不限)行骨盆CT三维重建.分别测量Click点至髂前下棘下缘(A)、髂后上棘至髂前下棘下缘(B)、髂后上棘至髋臼上壁(C)三条路径的有效路径长度,以及峡部内径宽度及峡部与进钉点的距离.结果与尸体髂骨测量结论一致,影像学测量结果示路径A拥有最长的有效路径长度,男性平均(137±8)mm,女性(130±11)mm.经由路径A、B可支持两枚髂骨钉的置入,两路径均允许置入男性长度100 mm,直径8 mm,女性长度80 mm,直径6～7 mm髂骨钉.结论相对于传统髂骨钉置入路径,Click点至髂前下棘下缘允许更长髂骨钉的置入而穿破髋臼的风险更小,为Galveston固定中髂骨钉置入最理想路径.
목적 통과성인시체가골형태해부학급영상학상관수거적측량여분석,탐토Galveston 고정중최이상적가골정치입로경.방법 보존완호적5구10측신선시체반골분,성별불한.우가골Chiotic선상방15 mm처매5 mm평행우해선절골,직지관구상연.분별측량절골면가골정치입유효로경장도、협부위치급내경관도.50례성인환자(성별불한)행골분CT삼유중건.분별측량Click점지가전하극하연(A)、가후상극지가전하극하연(B)、가후상극지관구상벽(C)삼조로경적유효로경장도,이급협부내경관도급협부여진정점적거리.결과 여시체가골측량결론일치,영상학측량결과시로경A옹유최장적유효로경장도,남성평균(137±8)mm,녀성(130±11)mm.경유로경A、B가지지량매가골정적치입,량로경균윤허치입남성장도100 mm,직경8 mm,녀성장도80 mm,직경6～7 mm가골정.결론 상대우전통가골정치입로경,Click점지가전하극하연윤허경장가골정적치입이천파관구적풍험경소,위Galveston고정중가골정치입최이상로경.
Objective To describle the satisfactory intrailiac paths in Galveston fixation combined with adult human cadaver and radiology study.Methods Five adult cadavers with 10 hemisectioned pelvises were harvested.Parallelly to the Chiotic line,the bone every other 5 mm till the superior rim of the acetabultim(SRA)observing the morphologic characteristics of each cross-sections of the iliac columns was cut. Fifty consecutive and randomly selected patients were measured using three-dimensional computed tomographic reformations.Three paths'valid bony canal lengths(LVBC),contractions'inner widths and positions were evaluated.Results The Path A with the longest LVBC(137±8)mm in male,(130±11)mm in female was the most satisfactory intrailiac path according to both adult cadaver and radiographic measurement.Path A and B allowed placement of 100 mm and 8 mm implants in male,80 mm and 6 to 7mm implants in female patients.Conclusion The Path A,passing from the Click point towards the bottom of the anterior inferior iliac spine provides a longer and potentially safer anchor site compared with the traditional path.