应用MIMICS软件对髋臼后柱顺行螺钉骨性通道参数的测量

Measurement of Bone Passage Parameters of Anterograde Screw in Posterior Column of Acetabular by MIMICS Software

目的运用MIMICS软件重建骨盆3D模型,研究髋臼后柱骨性结构,测量髋臼后柱顺行拉力螺钉骨性通道参数,为临床安全置入髋臼后柱螺钉提供理论依据。方法随机收集2017年1月～12月我院CT室健康成人的完整骨盆图像数据30例,男女各15例,应用Mimics软件重建骨盆3D模型。以坐骨结节为出钉点在髋臼后柱顺行置入虚拟螺钉,测量后柱顺行拉力螺钉骨性通道安全区的参数,比较各个参数在不同性别间的差异。结果螺钉AB及AC的长度、与矢状面夹角及与冠状面夹角在不同性别之间比较,差异有统计学意义(P<0.05)。螺钉AD的长度、与矢状面夹角在不同性别之间比较,差异有统计学意义(P<0.05);螺钉AD的长度与冠状面的夹角在不同性别之间比较,差异无统计学意义(P>0.05)。结论在髋臼后柱存在一个近似"四面体"的安全骨性通道,安全入钉点区域呈"三角形"。在安全骨性通道内置入6.5 mm的拉力螺钉在矢状面及冠状面可以有一定的调整角度。利用MIMICS软件有助于髋臼后柱拉力螺钉骨性通道的解剖学研究,为临床安全置钉提供理论依据。

Objective To reconstruct the pelvic3D model with MIMICS software,study the acetabular posterior column bone structure,and measure the osseous channel parameters of the acetabular posterior column anterior lag screw to provide a theoretical basis for clinically safe placement of the acetabular posterior column screw.Methods A total of30cases of intact pelvic image data of healthy adults in the CT room of our hospital from January to December2017were randomly collected.15cases of male and female were used to reconstruct the pelvic3D model using Mimics software.The virtual screws were placed in the acetabular posterior column with the ischial tuberosity as the nailing point.The parameters of the posterior column antegrade lag screw bone passage safety zone were measured,and the differences of various parameters between different genders were compared.Results The lengths of the screws AB and AC,the angle between the sagittal plane and the angle between the sagittal plane and the coronal plane were statistically significant(P<0.05).The length of the screw AD and the angle between the sagittal plane and the sagittal plane were statistically significant(P<0.05).The length of the screw AD and the angle of the coronal plane were compared between different genders.The difference was not statistically significant(P>0.05).Conclusion There is an approximately"tetrahedral"safety bony channel in the posterior column of the acetabulum.The safe entry point is"triangle".A6.5mm lag screw built into the safety bony channel can be adjusted at a certain angle in the sagittal and coronal planes.The use of MIMICS software can help the anatomy of the acetabular posterior column lag screw ossicular channel,providing a theoretical basis for clinical safety.