髋臼前柱拉力螺钉内固定的解剖学研究

Anatomical study of lag screw internal fixation in the anterior column of the acetabulum

目的:探讨髋臼前柱拉力螺钉内固定的解剖学基础。方法:取12个骨盆标本,其中男7个,女5个。于双侧髋臼中部垂直于前后柱表面截骨,以逆行法沿前柱中心打入一克氏针,其从髂骨后外侧穿出点为P点,作一参考线AB,其中A为坐骨大切迹顶点,B为髂前上、下棘切迹,由P点向AB作垂线,与AB相交于D点,与髋臼上缘相交于E点。然后测量以下数值:①AB,AD,PD,PE的距离;②骨盆俯卧位时前柱克氏针与水平面的夹角α,与矢状面的夹角β;③测量髋臼前柱截面的半径;④测量髋臼前柱克氏针在骨皮质内的长度。结果:PD是AB的中垂线。PD的距离男性为(1.59±0.25)cm,女性为(1.49±0.20)cm;PE的距离男性为(3.67±0.40)cm,女性为(3.28±0.12)cm;夹角α男性为(25.0±2.6)°,女性为(23.9±3.5)°;夹角β男性为(37.5±2.5)°,女性为(37.4±2.2)°;前柱截面的半径男性为(6.45±0.27)mm,女性为(6.34±0.34)mm;前柱克氏针的长度男性为(11.5±0.4)cm,女性为(11.2±0.5)cm。结论:髋臼前柱拉力螺钉内固定在解剖学上是可行的。

Objective：To study anatomical basis for the placement of lag screw in the acetabular anterior column.Methods：Twelve pelves,including seven male and five female pelves were studied.All specimens were sectioned across the middle of the acetabulum perpendicularly to the anterior and posterior surface.A Kirschner pin was forced retrogradely through the center of the anterior column.The exit point of the pin on the post-lateral surface of the iliac bone was named P.A designed line AB was drawn connecting the deepest portion of the incisura ischiadica major（A） and the interspinous notch of the spina iliaca anterior superior and inferior（B）.Line PD was perpendicular to the line AB.The intersectal of the line PD and AB was named D;the intersectal of the line PD and the superior margin of the acetabulum was named E.Then the following data were measured：①The distances of AB,AD,PD,PE.②The angle between the Kirschner pin of the anterior column and the horizontal plane（α）,the angle between the Kirschner pin of the anterior column and the sagittal plane（β）,when the pelvis was placed at prone position.③The radius of the cross-section of the anterior and column.④The length of the the Kirschner pin in the anterior column.Results：The PD was the middle vertical line of AB.The mean distance of PD was（1.59±0.25） cm for male and was（1.49±0.20）cm for female.The mean distance of PE was（3.67±0.40）cm for male and（3.28±0.12）cm for female.The mean angle α was（25.0±2.6）°for male and（23.9±3.5）°for female.The mean angle β was（37.5±2.5）°for male and（37.4±2.2）°for female.The mean radius of the anterior column’s cross-section was（6.45±0.27） mm for male and（6.34±0.34） mm for female.The mean length of the Kirschner pin in the anterior column was（11.5±0.4） cm for male and（11.2±0.5） cm for female.Conclusion： Lag screw internal fixation in the anterior column of the acetabulum is feasible from the anatomical basis.