髋臼后柱骨折顺行拉力螺钉置钉导向器的研究

目的为髋臼后柱拉力螺钉导向器提供解剖学基础。方法收集31具半骨盆骨性标本(男性14例,女性17例),在髋臼后柱顺行置入拉力螺钉导针,测量进钉点的位置和进针方向。结果进针点与弓状缘的垂直距离女性为(0.96±0.32)cm,男性为(0.92±0.16)cm(P0.05),进针点与骶髂关节前缘距离,女性为(2.43±0.66)cm,男性为(1.87±0.26)cm(P0.05)。进钉方向与髂骨内板的后倾角∠θ女性为(59.68±6.28)°,男性为(56.75±3.22)°(P0.05)、进钉方向与髂骨内板的外倾角∠φ女性为(41.27±2.76)°,男性为(34.31±2.78)°(P0.05)。结论髋臼后柱骨折顺行拉力螺钉进钉点和进钉方向的测量为导向器的设计提供了解剖学基础,有助于提高髋臼后柱骨折顺行拉力螺钉置钉的成功率和准确性,降低手术风险和减轻手术损伤。

Clinical anatomic study of the lag screw guide device for the acetabulum posterior column

Objective　To measure anatomical parameters of the guide device for antegrade lag screw fixation of the fractures in the posterior column of acetabulum.　Methods　17 females and 14 males semi pelvic bony specimens were collected for this clinical anatomic study. After successful implantation of the antegrade lag screw into the posterior column of acetabulum, the screw entry point and entry angle of inclination were separately measured and statistically analyzed.　Results　The average distance between the entry point and the arcuate margin was (0.96±0.32) cm in female and (0.92±0.16) cm in male (P>0.05), while the distance between the entry point and the sacroiliac joint front was (2.43±0.66) cm in female and (1.87±0.26) cm in male (P<0.05). The average retroversion angulation of screw was (59.68±6.28)°in female and (56.75±3.22)°in male (P>0.05）, while the extraversion angulation was (41.27±2.76)°in female and (34.31±2.78)°in male (P<0.05).　Conclusions　The results of our measurement can contribute to design of guide device for antegrade lag screw, which could improve the success rate and accuracy of the screw implantation in the posterior column of acetabulum, reduce the surgery risk, and minimize operative trauma.