中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
22期
9-12
,共4页
骶骨钉%骶髂关节%骨盆后环%进针点%应用解剖
骶骨釘%骶髂關節%骨盆後環%進針點%應用解剖
저골정%저가관절%골분후배%진침점%응용해부
Sacral nails%Sacroiliac joint%After pelvic ring%Needle points%Applied anatomy
目的 明确经髂后上棘植入髂骨螺钉的角度参数,对髂骨螺钉置入的可行性以及安全性进行全方位的探讨,为研制适合国人的髂骨钉提供参考数据.方法 采用18具防腐骨盆标本,对骨盆周围软组织仔细剔除.测量的数据有:①Sl椎弓根观测与测量.②采用该研究确立的进钉方法用骶骨钉治疗18例骨盆后环损伤患者,随访追踪其治疗效果.结果 (1)S1椎弓根测量结果:①椎弓根高(20.2±2.3)mm;②椎弓根宽(27.7±2.0)mm;③椎弓根中心至进针点距离(49.1±3.6)mm;④S1椎体对侧前皮质至进针点距离(86.5±3.8)mm;⑤坐骨大切迹上方(41.8±3.4)mm,髂后下迹前方(24.6±2.9)mm为其进针点;⑥垂直于髂骨翼后外侧面,向后侧倾斜(7.7±3.8)°,然后向尾端倾斜(7.1±2.3)°为其进针方向.(2)临床应用评价:18例标本中共放置19枚骶骨钉,术后X线拍片复查对比见骶骨钉位于骶1椎体和弓根内,位置良好,骨盆对位对线良好.结论 ①选长为75 mm骶髂关节螺钉固定经S1椎弓根水平为适宜;②骶髂关节螺钉固定经S1椎弓根水平的植入点位于髂后下棘前方25 mm,坐骨切迹上方40 mm;③垂直于髂骨翼后外侧面的植入方向,然后向尾端倾斜5°～10°,向后侧倾斜5 °～10°.
目的 明確經髂後上棘植入髂骨螺釘的角度參數,對髂骨螺釘置入的可行性以及安全性進行全方位的探討,為研製適閤國人的髂骨釘提供參攷數據.方法 採用18具防腐骨盆標本,對骨盆週圍軟組織仔細剔除.測量的數據有:①Sl椎弓根觀測與測量.②採用該研究確立的進釘方法用骶骨釘治療18例骨盆後環損傷患者,隨訪追蹤其治療效果.結果 (1)S1椎弓根測量結果:①椎弓根高(20.2±2.3)mm;②椎弓根寬(27.7±2.0)mm;③椎弓根中心至進針點距離(49.1±3.6)mm;④S1椎體對側前皮質至進針點距離(86.5±3.8)mm;⑤坐骨大切跡上方(41.8±3.4)mm,髂後下跡前方(24.6±2.9)mm為其進針點;⑥垂直于髂骨翼後外側麵,嚮後側傾斜(7.7±3.8)°,然後嚮尾耑傾斜(7.1±2.3)°為其進針方嚮.(2)臨床應用評價:18例標本中共放置19枚骶骨釘,術後X線拍片複查對比見骶骨釘位于骶1椎體和弓根內,位置良好,骨盆對位對線良好.結論 ①選長為75 mm骶髂關節螺釘固定經S1椎弓根水平為適宜;②骶髂關節螺釘固定經S1椎弓根水平的植入點位于髂後下棘前方25 mm,坐骨切跡上方40 mm;③垂直于髂骨翼後外側麵的植入方嚮,然後嚮尾耑傾斜5°～10°,嚮後側傾斜5 °～10°.
목적 명학경가후상극식입가골라정적각도삼수,대가골라정치입적가행성이급안전성진행전방위적탐토,위연제괄합국인적가골정제공삼고수거.방법 채용18구방부골분표본,대골분주위연조직자세척제.측량적수거유:①Sl추궁근관측여측량.②채용해연구학립적진정방법용저골정치료18례골분후배손상환자,수방추종기치료효과.결과 (1)S1추궁근측량결과:①추궁근고(20.2±2.3)mm;②추궁근관(27.7±2.0)mm;③추궁근중심지진침점거리(49.1±3.6)mm;④S1추체대측전피질지진침점거리(86.5±3.8)mm;⑤좌골대절적상방(41.8±3.4)mm,가후하적전방(24.6±2.9)mm위기진침점;⑥수직우가골익후외측면,향후측경사(7.7±3.8)°,연후향미단경사(7.1±2.3)°위기진침방향.(2)림상응용평개:18례표본중공방치19매저골정,술후X선박편복사대비견저골정위우저1추체화궁근내,위치량호,골분대위대선량호.결론 ①선장위75 mm저가관절라정고정경S1추궁근수평위괄의;②저가관절라정고정경S1추궁근수평적식입점위우가후하극전방25 mm,좌골절적상방40 mm;③수직우가골익후외측면적식입방향,연후향미단경사5°～10°,향후측경사5 °～10°.
Objective To clarify the angle parameters of ilium after implantation screw nails way,and the feasibility of the ilium screw placement and security,in order to provide the reference of ilium nail.Methods Einhteen anticorrosion pelvic specimens were chosen,the soft tissue of peluic area carefully done.The measurement data were:①the S1 pedicle observation and measurement.②using sacral nailing with the nothod of this study for 18 pelvic ring posterior injury patients and follow-up its therapeutic effect.Results (1)the S1 pedicle measurement results:① The S1 pedicle height (20.2 ± 2.3) mm.②S1 pedicle width (27.7 ±2.0) mm.③S1 point to needle into the pedicle center distance (49.1 ±3.6) mm.④The needle point to S1 cortex of vertebral body before side range (86.5 ± 3.8) mm.⑤The needle point located at S1 under ahead after iliac mark(24.6 ±2.9) nun,above greater sciatic notch(41.8 ±3.4) mm.⑥Direction perpendicular to the needle for the lateral aspect of the ilium after wing,then end to tilt (7.1 ±2.3)°,back to tilt(7.7 ±3.8)°.(2)Clinical application evaluation:18 cases of sacral was placed for 19 sacral nail,and the X-ray films review showed sacral nail is normally located in S1 pedicle and vertebral body,and pelvic reset is also good.Conclusions ①The sl pedicle sacroiliac joint screws should choose long for 75 mm screws for appropriate.②The S1 pedicle level sacroiliac joint screws into the needle is located in the point of sciatic cut trace 40 mm above,after coming under the front was 25 mm.③The direction perpendicular to the needle for the lateral aspect of the ilium after wing,then end to tilt 5°-10°,back to tilt 5°-10°.
