钢板置入内固定髋臼后柱骨折中螺钉的最佳进钉点

背景：骨盆骨折和髋臼骨折切开复位内固定过程中有时会发生螺钉穿入关节内、损伤盆腔内重要血管或神经等严重并发症。目的：探讨髋臼后柱钢板内固定技术中螺钉的最佳进钉点、方向和长度。方法：取成年男性半骨盆标本20个,制作髋臼后柱系列断面,测量各进钉点的螺钉进钉角度和长度。结果与结论：各断面在髋臼缘、外中1/4点、中点、内中1/4点和髋臼后柱内缘的进钉安全角度分别为39°、57°、74°、90°和106°,螺钉长度分别为39,57,74,90和106mm。在髋臼区的外1/4区、外中1/4区、内中1/4区和内1/4区,钉后柱角分别为40°-60°、60°-75°、75°-90°、90°-平行于四方区,螺钉长度30mm。

Optimal entry points of screw in internal fixation of acetabular posterior column fracture with plate

BACKGROUND： Recently, open reduction and internal fixation has become a common therapy for pelvic and acetabular fractures. However, screw penetration sometimes damages important vessels or nerves in the pelvic cavity during the internal fixation. OBJECTIVE： To investigate the optimal entry points, direction and length of screw in acetabular posterior column plate technique, and to prevent the serious complications caused by screw penetrating the joint surface. METHODS： Twenty male cadaveric adult semipelvic specimens were taken and prepared into serial cross-sections of the acetabular posterior column. The safe angle of screw entry and the length on all entry points of each cross-section were measured. All data were input into software SPSS 10.0 for statistical process. RESULTS AND CONCLUSION： On margin of acetabulum, lateral-middle 1/4 point, midpoint, medial-middle 1/4 point and medial margin of posterior column of each cross-section, safe entry angle of inclination was 39°, 57°, 74°, 90° and 106°respectively, the length of the screw was 39, 57, 74, 90 and 106 mm respectively. On lateral 1/4 region, lateral-middle 1/4 region, medial-middle 1/4 region and medial 1/4 region, screw posterior column angle was 40°-60°, 60°-75°, 75°-90°, 90°-parallel to the quadrilateral plate, and the length of the screw was 30 mm.