骶骨纵形骨折后路钢板固定置钉的应用解剖

目的 通过对骶骨的解剖学测量，为骶骨纵形骨折后路钢板固定的临床应用提供钉道基础数据。方法 选取20例成人骶骨标本，按骶骨后路钢板固定置钉的钉道要求，设定进针点：骶（S1）关节突外侧a点，S1关节突下侧b点，S2、S3、S4的入点c、d、e位于a点与S4骶骨后孔假想连线上，且各位于上下骶骨后孔间连线的中点处；两侧进针点间的距离分别为af、bg、ch、ci、dj、ek；内侧钉道长度分别为A1、A2、B、C、D、E；外侧钉道长度分别为F、G、H、I、J、K和外侧钉道角度分别为Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ。结果A1、A2、B值分别为(31.70±3.54)mm、(35.59±4.50)mm和(27.83±3.80)mm； F、G、H、I、J值分别为(43.68±5.11)mm、(30.10±4.00)mm、(27.66±3.33)mm、(23.51±3.26)mm和(18.72±4.18)mm；Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ值分别为(5.75±4.14)°、(12.65±5.22)°、(10.05±6.78)°、(8.75±5.87)°和(16.33±8.46)°。结论 内外侧置钉进针点间距离适合钢板的使用；置钉钉道长度内侧相对固定，外侧多变；外侧置钉角度变化较大。

Applied anatomy of the screw placement of the posterior internal fixation with a steel plate for vertical sacral fractures

Objective To provide basic data of the screw channel for the clinical application of the posterior internal fixation with a steel plate for vertical sacral fractures through the anatomic measurement of the sacrum.Methods According to the requirement of the screw channel of the sacral posterior internal fixation with a steel plate, the inserting sites were determined on 20 cases of the selected adult sacrum specimens: point a at the in lateral side of S1 articular process, point b at the downside of S1 articular process, points c, d and e of S2, S3 and S4 along the imaginary line between point a and the top edge of S4 dorsal sacral foramina, respectively, at the midpoint of the line between adjacent dorsal sacral foraminas. The distances between inserting sites were af, bg, ch, ci, dj and ek, respectively; the lengths of inside screw channels were A1, A2, B, C, D and E, respectively; the lengths of outside screw channels were F, G, H, I, J and K, respectively and the angles of outside screw channels were Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴand Ⅵ, respectively. Results A1, A2 and B values were (31.70±3.54)mm, (35.59±4.50)mm and (27.83±3.80)mm, respectively; F, G, H, I and J values were (43.68±5.11)mm, (30.10±4.00)mm, (27.66±3.33)mm, (23.51±3.26)mm and (18.72±4.18)mm,