CAJ | 학술논문

目的应用数字化技术探讨髋臼后柱的形态学特点,以期设计出适合髋臼后柱骨折内固定的解剖型接骨板. 方法收集2008年1月至2012年3月期间收治的111例成年患者[男72例,女39例;平均年龄为(45.4±15.7)岁]正常侧骨盆CT数据进行三维重建,在模型中分别测量股骨头直径、髋臼后柱接骨板途经的髋臼后壁、近端及远端3段近似圆弧的曲率半径(R1、R2和R3),以及反映3段圆弧相对位置关系的角度(α).比较以上各形态学参数在性别间的差异,探讨其相关性,并基于结果指导髋臼后柱解剖型接骨板的设计. 结果股骨头直径平均为(47.43 ±3.74) mm;髋臼后柱参数:R1平均为(47.96 ±7.80) mm,R2平均为(67.71±13.35) mm,R3平均为(9.76±0.43) mm,α平均为51.38°±6.83°.男、女性之间股骨头直径及α比较差异均有统计学意义(P＜0.05),而R1、R2、R3比较差异均无统计学意义(P＞0.05).髋臼后柱4个形态参数中除α外,R1、R2、R3与股骨头直径均无相关性.而R2与R1呈正相关,α与R1、R2呈负相关,R3具有相对独立性.本研究以R1值为参考,将数据分为3组,据此拟合出3种髋臼后柱骨面的曲率形态,并成功设计出了3种规格的解剖型接骨板.结论髋臼后柱的解剖结构存在很大的个体差异.本研究通过对髋臼后柱骨折复位质量及临床可接受的误差范围的权衡成功设计出了3种解剖型接骨板,其较传统的解剖型接骨板设计更为合理.
목적 응용수자화기술탐토관구후주적형태학특점,이기설계출괄합관구후주골절내고정적해부형접골판. 방법 수집2008년1월지2012년3월기간수치적111례성년환자[남72례,녀39례;평균년령위(45.4±15.7)세]정상측골분CT수거진행삼유중건,재모형중분별측량고골두직경、관구후주접골판도경적관구후벽、근단급원단3단근사원호적곡솔반경(R1、R2화R3),이급반영3단원호상대위치관계적각도(α).비교이상각형태학삼수재성별간적차이,탐토기상관성,병기우결과지도관구후주해부형접골판적설계. 결과 고골두직경평균위(47.43 ±3.74) mm;관구후주삼수:R1평균위(47.96 ±7.80) mm,R2평균위(67.71±13.35) mm,R3평균위(9.76±0.43) mm,α평균위51.38°±6.83°.남、녀성지간고골두직경급α비교차이균유통계학의의(P＜0.05),이R1、R2、R3비교차이균무통계학의의(P＞0.05).관구후주4개형태삼수중제α외,R1、R2、R3여고골두직경균무상관성.이R2여R1정정상관,α여R1、R2정부상관,R3구유상대독립성.본연구이R1치위삼고,장수거분위3조,거차의합출3충관구후주골면적곡솔형태,병성공설계출료3충규격적해부형접골판.결론 관구후주적해부결구존재흔대적개체차이.본연구통과대관구후주골절복위질량급림상가접수적오차범위적권형성공설계출료3충해부형접골판,기교전통적해부형접골판설계경위합리.
Objective To design anatomical plates for internal fixation of acetabular posterior column fracture on the basis of digital morphological characterization of the acetabular posterior column.Methods From January.2008 to March 2012,three-dimensional (3D) reconstruction models of the pelvis were developed from CT scan data of 111 adult patients (72 men and 39 women,45.4 ± 15.7 years of age).Diameters (D) of the femoral head,radius of curvature (R1,R2 and R3) of the 3 approximate arcs along the acetabular posterior column plate,and the angle α reflecting the relative positions of the 3 arcs were measured,respectively.Independent sample t-test and Pearson correlation analysis were used to analvze the differences between genders and the correlation of the above morphological parameters.Anatomical plates of the acetabular posterior column were designed according to the analyses.Results On average,D was 47.43±3.74 mm,R1 47.96±7.80 mm,R267.71±13.35 mm,R3 9.76±0.43 mm and α51.38°± 6.83°.There was a significant difference between male and female regarding α and D (P ＜ 0.05),but no significant difference regarding R1,R2 and R3 (P ＞ 0.05).R1,R2 and R3 had no correlation with D.R2 had a positive correlation with R1 while α had a negative correlation with R1 and R2.R3 was relatively independent.Taking R1 as the basic reference,the data were divided into 3 groups to determine 3 curvature forms of the bone surface of the acetabular posterior column.Three types of anatomical plates were subsequently designed.Conclusions The anatomical structure of the acetabular posterior column varies greatly from individual to individual.This study has designed 3 anatomical plates for acetabular posterior column fracture which are more reasonable than conventional ones because they take into consideration both the reduction quality and clinically acceptable errors.