骨盆后环骨折神经损伤的临床解剖学研究

目的：了解骨盆后环骨折易损神经的相对解剖位置及其与骨折的关系。方法：解剖20具骨盆标本，神经外膜下置管造影CT扫描5例，测量腰区各神经的走行特点、与骨盆壁和骶髂关节的距离。结果：腰4腰骶干支、腰5神经和腰骶干与骶骨翼的距离不超过1cm，距离骶髂关节不超过2．5cm。闭孔神经、股神经、股外侧皮神经与骨壁的距离依次渐远。CT测量结果和人工测量结果无显著性差异。结论：腰4腰骶干支、腰5神经和腰骶干是与骨盆壁和骶髂关节的关系最为紧密的神经，它们在骨盆后环骨折及其治疗时最易受损。

The clinical anatomic study on the nerve injury of the posterior ring pelvic fracture

Objective: To explore the relative dissective position of the nerves injuried easily at the fracture of pelvic posterior ring and study the relationship between the nerves with pelvic wall and sacroiliac joint. Methods: 20 pelvises were dissected. 5 samples were put tubes of visualization under the adventitia and scaned on CT. The course characters of pelvic nerves in the Sacroiliac region and the relationships between nerves with pelvic sides and sacroiliac joint were invested. Results: The distamce from L_4 , L_5 nerve and lumbosacral trunk to the sacroiliac joint were no more than 2.5 cm , and 1.0cm was the maximal distance to the sacral bone wall. The obturator nerve, femoral nerve and the lateral femoral cutaneous nerve gradually departed from the bone wall. There was no significant difference between the results of man-made with CT. Conclusion: For the tight relationship with the sacroiliac joint and the bone wall, L_4 , L_5 nerve and lumbosacral trunk are easy to be injured in the pelvic posterior ring fracture and in the operation.