骶髂关节骨折脱位前路手术的应用解剖

目的　为临床前路手术治疗骶髂关节骨折脱位提供解剖学依据。 方法　成年防腐盆部标本20具（40侧），解剖观察髂内动静脉、髂腰动静脉与骶髂关节的位置关系，测量L4、5神经前支及腰骶干与骶髂关节的毗邻关系。 结果　髂内动脉横跨骶髂关节处的外径左侧为(5.92±0.7)mm，右侧为(5.38±　0.7)mm，起始处距骨壁距离左侧为(11.91±2.4)mm，右侧为(12.52±2.9)mm，髂腰动脉横跨骶髂关节处的外径为(2.54±0.39)mm，起始处距骨壁的距离为(2.50±0.41)mm。骶髂关节从后上到前下的不同平面到L4、5神经前支及腰骶干的距离逐渐减小，L4神经根前支距离骶骨翼骨面的垂直距离亦逐渐减小，L5神经根出椎间孔后，几乎紧贴骶骨翼骨面行走。 结论　骶髂关节骨折脱位前路手术要特别注意医源性血管神经的损伤，L5神经根易受损伤，安全放置钢板的位置是骶骨翼中上部，距骶骨翼边缘20 mm以内。

Anterior approach for treating fracture dislocation of iliosacral articulation: applied anatomic study

Objective To provide anatomic evidence for treating fracture dislocation of iliosacral articulation through the anterior approach.Methods The study was performed in 20 adult antiseptic pelvic specimen(from 40 corpses).The relationship of the internal iliac vessels and the lumbar vessels with acroiliac articulation were explored.The distances from the anterior branches of L4,5 spinal nerves to the lumbosacral trunk and sacroiliac joint were measured.Results The external diameters of the left and right intern...