数字化仿真技术在髋臼前柱安全置钉的研究

The study of safe lag screw placement in the anterior column of acetabulum by the digital simulation technique

目的利用数字化仿真技术求解髋臼前柱的安全置钉通道。方法通过将48例正常成人骨盆CT图像导入Mimics15.0中进行数字化处理得到96例髋臼前柱阴模模型,结合立体解析几何求解髋臼前柱的安全置钉通道。结果安全置钉通道:最大半径男性为(4.65±0.54)mm,女性为(3.71±1.68)mm;进钉深度男性为(114.91±6.52)mm,女性为(102.97±6.24)mm;进钉最狭窄处位于髋臼前壁内,最狭窄处到顺行进钉点的距离:男性为(34.57±2.16)mm,女性为(29.82±1.94)mm;最狭窄处到逆行进钉点的距离:男性为(73.32±3.27)mm,女性为(69.49±2.52)mm;螺钉与水平面夹角男性为(45.22±1.54)°,女性为(43.59±3.24)°;螺钉与矢状面夹角男性为(41.65±5.37)°,女性为(47.82±4.12)°;螺钉与冠状面夹角男性为(18.71±2.36)°,女性为(19.23±2.49)°。安全进钉通道参数男女对比"最大半径"、"进钉深度"、"螺钉与矢状面夹角"有统计学意义(P<0.05)。结论利用数字化仿真技术能够精确求解髋臼前柱安全置钉通道。

Objective To find and measure the safe lag screw placement channel（SLSC） in the anterior column of acetabulum by the digital simulation technique（DST）. Methods To find and measure the safe lag screw placement channel in the anterior column of the acetabulum under the standard 3D coordinate system and the three- dimensional coordinate system of the pelvis by establishing 96 cases of 3D finite element female die of the anterior column of acetabulum through 3D reconstruction of 48 cases of normal adult pelvic spiral CT data by Mimics 15.0. Results The parameters of SLSC of the anterior column of acetabulum： The max radius is（4.65±0.54）mm in male, and（3.71±1.68）mm in female; The depth is（114.91±6.52）mm in male, and（102.97±6.24）mm in female; The narrowest screw placement site is in the anterior wall of the acetabulum, and the distance between the narrowest screw placement site and direct penetrating site ：Male is（34.57 ± 2.16）mm, and female is（29.82 ± 1.94）mm; The distance between the narrowest screw placement site and retrograde penetrating site： Male is（73.32 ± 3.27）mm, and female is（69.49±2.52）mm; The angle with the horizontal plane is（45.22±1.54）° in male,and（43.59±3.24）° in female;The angle with the sagittal plane is（41.65 ± 5.37）° in male, and（47.82 ± 4.12）in female; The angle with the coronal plane is（18.71±2.36）° in male, and（19.23±2.49）° in female. The max radius, the depth of the screw,the angle with the longitudinal sectional plane showed sex- related statistical differences（P0.05）.Conclusions： DST can accurately measure the SLSC of the anterior column of acetabulum.