CAJ | 학술논문

目的通过骨盆数字化三维重建模型探讨髋臼后柱及股骨头的解剖形态学特征,为术中接骨板塑形及髋臼后柱解剖型接骨板的研发提供依据.方法 111例因单侧髋臼、骨盆损伤行骨盆螺旋CT扫描的成年患者,男72例,女39例；年龄18～80岁,平均45.4岁.依据CT扫描数据建立骨盆数字化三维模型.于模型中测量股骨头直径,髋臼后柱接骨板途经的髋臼后壁、近端、远端三段近似圆弧的曲率半径(R1、R2和R3)和反映三段圆弧相对位置关系的髋臼后壁圆弧展角.结果股骨头直径平均(47.43±3.74) mm,R1 (47.96±7.80) mm,R2(67.71±13.35) mm,R3 (9.76±0.43) mm,髋臼后壁圆弧展角平均51.38°±6.83°.男女两组股骨头直径及髋臼后壁圆弧展角的差异有统计学意义(t=12.37,P=0.00；t=2.63,P=0.01),而R1、R2、R3两组差异无统计学意义(t=1.05,P=0.30；t=1.36,P=0.18；t=0.72,P=0.47).髋臼后壁圆弧展角与股骨头直径呈正相关(r=0.37,P=0.00),R1、R2和R3与殷骨头直径不相关(r=0.09,P=0.34；r=0.08,P=0.43；r=-0.00,P=0.98).R2总体上随R1增大而增大,髋臼后壁圆弧展角随R1及R2增大而减小,R3变化范围不大.结论髋臼后柱的解剖形态存在个体差异,其形态与股骨头直径及患者性别不相关,其中髋臼后壁弧度是决定髋臼后柱接骨板形态的主要因素.
목적 통과골분수자화삼유중건모형탐토관구후주급고골두적해부형태학특정,위술중접골판소형급관구후주해부형접골판적연발제공의거.방법 111례인단측관구、골분손상행골분라선CT소묘적성년환자,남72례,녀39례；년령18～80세,평균45.4세.의거CT소묘수거건립골분수자화삼유모형.우모형중측량고골두직경,관구후주접골판도경적관구후벽、근단、원단삼단근사원호적곡솔반경(R1、R2화R3)화반영삼단원호상대위치관계적관구후벽원호전각.결과 고골두직경평균(47.43±3.74) mm,R1 (47.96±7.80) mm,R2(67.71±13.35) mm,R3 (9.76±0.43) mm,관구후벽원호전각평균51.38°±6.83°.남녀량조고골두직경급관구후벽원호전각적차이유통계학의의(t=12.37,P=0.00；t=2.63,P=0.01),이R1、R2、R3량조차이무통계학의의(t=1.05,P=0.30；t=1.36,P=0.18；t=0.72,P=0.47).관구후벽원호전각여고골두직경정정상관(r=0.37,P=0.00),R1、R2화R3여은골두직경불상관(r=0.09,P=0.34；r=0.08,P=0.43；r=-0.00,P=0.98).R2총체상수R1증대이증대,관구후벽원호전각수R1급R2증대이감소,R3변화범위불대.결론 관구후주적해부형태존재개체차이,기형태여고골두직경급환자성별불상관,기중관구후벽호도시결정관구후주접골판형태적주요인소.
Objective To investigate the morphological characteristics of the posterior acetabular column and the femoral head by three-dimensional reconstruction models for providing an anatomical basis for intraoperative plate molding and the development of anatomical plate of the posterior acetabular column.Methods Three-dimensional reconstruction models of the pelvis were established based on CT scan data of 111 adult patients,including 72 males and 39 females,aged from 18 to 80 years (average,45.4 years).According to the models,the femoral head diameter was tneasured; along the posterior acetabular column plate path,three approximate arcs with a corresponding radius of curvature (R1,R2 and R3) were created to fit the posterior wall,proximal end and distal end of the acetabulum.The angle α,which reflected the relative position between the three arcs,was recorded.Results The average femoral head diameter,R1,R2,R3 and angle α was 47.43±3.74 mm,47.96±7.80 mm,67.71±13.35 mm,9.76±0.43 mm and 51.38°±6.83°,respectively.There was statistical difference in femoral head diameter and angle α between females and males (t=12.37,P=0.00; t=2.63,P=0.01),while no statistical difference was found in R1,R2 and R3 between them (t=1.05,P=0.30; t=1.36,P=0.18; t=0.72,P=0.47).There was a positive correlation between the femoral head diameter and angle α (r=0.37,P=0.00),while no correlation was found between the femoral head diameter and R1,R2 and R3 (r=0.09,P=0.34; r=0.08,P=0.43; r=-0.00,P=0.98).R2 increased with R1,while angle α decreased with increase of R1 and R2,and R3 was independent with a little variation.Conclusion The morphology of the posterior acetabular column has variances among individuals,with no obvious correlations with femoral head diameter and gender.The radian of posterior acetabular wall determines the shape of the posterior acetabular column plate.