髂后上棘的解剖形态学分型及临床意义

Anatomical classification of posterior superior iliac spine and its clinical significance

目的研究髂后上棘的解剖学特征及其临床意义。方法选取280例干燥人体髋骨标本,以髂后上棘为A点,髂前上棘为B点,坐骨结节为C点,髂棘最高点为D点,耻骨结节为E点,耳状关节面后缘中点为F点,髂后上棘尖端A点的宽度为W_(0),A点的厚度为H_(0)。髂嵴后部最大宽度为W_(max),其与A点的距离为D0,分别距离A点0.5、1.0、1.5、2.0 cm测量髂嵴的宽度,记为W_(1)、W_(2)、W_(3)、W_(4),以髂嵴转折部为G点,G点宽度记为W_(5),分别测量AB,AC,AD,AE,AF,G,CD长度。结果髂后上棘形态大致分为4型:Ⅰ型“V”形(38.2%),Ⅱ型“U”形(43.2%),Ⅲ型“W”形(11.1%),Ⅳ型“增生型”(7.5%)。Ⅰ型的AB长度显著小于Ⅲ型和Ⅳ型,Ⅰ型的AF距离显著小于Ⅱ型和Ⅲ型,Ⅰ型的W_(0)、W_(1)、H_(0)显著小于Ⅱ型、Ⅲ型、Ⅳ型,Ⅲ型的W_(0)大于Ⅰ型Ⅱ型和Ⅳ型,均具有统计学意义(P<0.05)。结论髂后上棘有4种形态变异,以“U”形为主,具有一定的临床指导意义。

Objective To study the anatomical characteristics of posterior superior iliac spine and explore its clinical significance.Methods Two hundred and eighty dry hip specimens of humans were selected.The posterior superior iliac spine was point A,the anterior superior iliac spine was point B,the ischial tuberosity was point C,the highest point of the iliac spine was point D,the pubic tuberosity was point E,and the midpoint of the posterior edge of the articular surface was point F.The width of point A of the posterior superior iliac spine was W_(0),and the thickness of point A was H_(0).The maximum width of the posterior part of the iliac crest was Wmax,and the distance from point A to the posterior part of the iliac crest was D_(0).The width of the iliac crest was measured at 0.5 cm,1.0 cm,1.5 cm,and 2.0 cm from point A,which were recorded as W_(1),W_(2),W_(3),W_(4).The part of the iliac crest was taken as point G and the width of point G was denoted as W_(5).The lengths of AB,AC,AD,AE,AF,AG,and CD were measured,respectively.Results The morphology of the posterior superior iliac spine was roughly divided into the following 4 types:type I"V"(107 cases,accounting for 38.2%),type II"U"(121 cases,accounting for 43.2%),type Ⅲ"W"(31 cases,accounting for 11.1%),type IV"Proliferative"(21 cases,accounting for 7.5%).The AB length of typeⅠwas significantly shorter than that of typeⅢandⅣ,the AF distance of typeⅠwas significantly shorter than that of typeⅡandⅢ.W_(0),W_(1) and H_(0) of typeⅠwere significantly smaller than that of typeⅡ,Ⅲ,andⅣ,and W_(0) of typeⅢwas greater than that of type I,type II and type IV,all were statistically significant(P<0.05).Conclusions There are 4 morphological variations of the posterior superior iliac spine,with a"U"shape as the main one,which has of certain clinical implication.