髋臼后柱数字解剖学研究及解剖钢板的设计

Digtial anatomic study of the posterior column of acetabulum and designing of anatomic plate

目的通过CT断层扫描数据的三维重建模型对髋臼后柱形态特点进行解剖学测量,为术中钢板成型及髋臼后柱解剖型钢板开发提供依据。方法采集111位成人患者(男72例,女39例)骨盆CT数据,测量股骨头直径(D);并分别通过CT断层扫描的三维反求技术重建人体骨盆解剖结构模型,测量髋臼后柱钢板放置路径中髋臼后壁、近端、远端的3段近似圆弧的曲率半径(R1、R2和R3),以及反应三段圆弧相对位置关系的髋臼后壁圆弧展角;对以上数据进行统计和相关性分析。结果成人股骨头直径(D):47.4±3.7mm;其中女性为43.6±2.3mm,男性为49.5±2.5mm。R1:48.0±7.8mm;R2:67.7±13.4mm;R3:9.8±0.4mm。:51.4°±6.8°。统计分析结果显示反应髋臼后柱钢板路径中的R1、R2、R3和与股骨头直径D和性别均无相关性。R3体现出相对独立性,其尺寸变化范围不大;而R2总体上随着R1增大而增大(线性相关系数R=0.388),而髋臼后壁圆弧展角随着R1的增大而降低(线性相关系数R=0.735)。结论髋臼后柱的解剖结构存在很大的个体差异,这种差异与股骨头直径、性别无明显相关性。髋臼后壁的形态决定了髋臼近端以及远端骨盆形态。新型髋臼后柱解剖钢板的应用,能够与髋臼后柱相匹配,缩短术中钢板塑形时间。

Objective Based on the 3D reconstruction of CT scan data, anatomical measurements were conducted to understand the morphological characteristics of acetabular posterior column and the relationship between acetabular pos- terior column plate path features and femoral head diameter, which could provide the basis for the intraoperative plate for- ming and the development of acetabular posterior column anatomical plate. Method Pelvic CT data of 111 adult patients （male 72 subjects, female 39 subjects） were collected to create the human pelvis anatomical model by the CT scanning ＆ 3D reconstruction technology. Each femoral head diameter （D） was measured. Along the acetabular posterior column plate path, 3 approximate arcs with corresponding radius of curvature Rj, R2 and R3, were created to fit to acetabular posterior wall, the proximal and the distal. As well, the circular arc comer a, which reflected the relative position relationship between the three arcs, was recorded. Results The statistical analysis results show D was 47.4±3.7mm （female 43.6±2.3mm; male 49.5±2.5mm）, R1 is 48.0±7.8mm; R2 is 67.7±13.4mm; tL is 9.8±0.4mm and a is 51.4°±6.8°. The acetabular posterior column plate path R1, R2, R3 and ct have no correlation with femoral head diameter D or gender. 1L is a relatively independent parameteter with size changes in the small range. On the whole, R2 increases with R1 （linear correlation coefficient R=0.388）, while ct is inversely proportional to R1（linear correlation coefficient R=0.735）. Con- clusion Acetabular posterior column anatomical structure has greatly individual differences, without obvious correlation with femoral head diameter or gender. Applying of this kind of new designed plate can match to the posterior column well. The time of forming the plate will be shorten.