髋臼闭孔后缘螺钉通道解剖学参数的研究

Anatomic parameters of the screw channel in the posterior margin of the obturator

目的为闭孔后缘螺钉通道置钉提供解剖学依据。方法收集50例正常成人骨盆(男女各25例)CT扫描数据,"轴位透视法"在半骨盆三维重建模型上测量闭孔后缘螺钉通道置钉参数,并于13具半骨盆骨性标本上验证。结果最大螺钉直径男、女性分为(6.48±1.07)mm、(5.87±1.34)mm,最大螺钉长度男、女性分为(98.03±4.08)mm、(87.34±4.76)mm;OA值男、女性分为(7.93±2.30)mm、(3.77±1.37)mm,AB值男、女性分为(55.99±4.83)mm、(63.66±4.74)mm;∠θ男、女性分为(79.17±9.89)°、(71.81±10.61)°;∠ψ男、女性分为(108.72±6.13)°、(98.12±7.43)°。所有的测量参数均存在男女之间的统计学差异(P<0.05)。13具半骨盆骨性标本除1例女性标本外均于该通道成功置入1枚3.5 mm克氏针。结论根据测量所得参数,于闭孔后缘螺钉通道置入一枚长度合适、直径至少为3.5 mm的拉力螺钉是可行的,可以此为基础设计相关置钉瞄准装置。

Objective To provide evidence of anatomy for the placement of screws in the screw channel in the posterior margin of the obturator. Methods CT scan data of 50 normal adults was collected for the reconstruction of three-dimensional hemi-pelvic models. The screw channel of each pelvis was confirmed using a novel method of axial perspective. After successful implantation of a virtual screw, the entry point and entry angle were measured. The data were verified on 13 bony hemi-pelvic specimens. Results The mean maximum screw diameter was（6.48 ± 1.07）mm in male and（5.87 ± 1.34）mm in female;the mean maximum screw length was（98.03±4.08）mm in male and（87.34±4.76）mm in female. The average OA value was（7.93 ± 2.30）mm in male and （3.77 ± 1.37）mm in female;the average AB value was（55.99 ± 4.83）mm in male and（63.66 ± 4.74）mm in female. The average∠θwas（79.17 ± 9.89）° in male and（71.81 ± 10.61）° in female, while the average ∠ψ was（108.72 ± 6.13）° in male and（98.12 ± 7.43）° in female. All the parameters were statistically significant （P〈0.05）. A Kirschner wire with a diameter of 3.5 mm was successfully implantedin each of the 12 hemi-pelvic bony specimens among 13 hemi-pelvic bony specimens. Conclusions It＇s feasible to implant a lag screw, which is at least 3.5 mm in diameter, into the screw channel in the posterior margin of the obturator. The parameters can be used for the design of the targeting device for this screw channel.