椎弓根钉━髂骨钉系统内固定治疗骶髋关节脱位的CT影像解剖学研究

目的 探讨基于CT数据建立腰-骶-髂复合体的数字模型，应用数字骨科技术为临床上采用联合椎弓根钉-髂骨钉系统内固定治疗骶髂关节骨折脱位提供理论依据。 方法 采用40例正常骨盆CT平扫数据，用mimics10.0软件进行三维图像重建，并在虚拟的髂骨上模拟髂骨钉的置入，测量不同进钉方向时进钉角度及髂骨钉的解剖参数。 结果 进钉方向Ⅰ：髂骨内外板之间的距离（即容纳髂骨螺钉的最大直径）（6.00±0.84）mm，能置入螺钉的长度（59.97±7.99）mm，TSA（12.48±7.16）°，CSA（56.41±　6.47）°，SSA（29.91±5.55）°。进钉方向Ⅱ：髂骨内外板之间的距离（即容纳髂骨螺钉的最大直径）（6.95±　0.50）mm，能置入螺钉的长度（106.69±8.74）mm，TSA（43.93±6.09）°，CSA（39.25±6.11）°，SSA（19.24±　3.78）°。 结论　数字骨科模型能更好的指导临床上采用椎弓根钉系统治疗骶髋关节脱位。

The pedicle and iliac screw fixation in treatment of sacroiliac dislocation and fracture: CT tomography study

Objective To investigate the value of digital model on evaluating pedicle screw and iliac screw in treating sacroiliac dislocation and fracture.Methods The pelvic CT data from 40 healthy adults were imported into the Mimics 10.0 software for three-dimensional reconstructing of pelvis.The anatomic parameters concerning with inserting angles and the ilium screws at different directions were measured on the virtual pelvis.Results The distance between lateral and medial ilium lamella(the maximum diameter of ilium screw)was about(6.00±0.84)mm,or(6.95±0.50)mm.The length of screw inserting was(59.97±7.99)mm,or(106.69±8.74)mm.TSA was(12.48±7.16)° or(43.93±6.09)°,CSA(56.41±6.47)° or(39.25±6.11)°,and SSA(29.91±5.55)° or 19.24±3.78)° at the different inserting direction,respectively.Conclusions Digital pelvic model is a valuable tool to guide clinical treatment of sacroiliac dislocation and fracture through pedicle screw and iliac screws.