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髋臼后柱顺行螺钉置入的3D影像测量研究

3D imaging measurement of anterograde screw placement in the posterior column of the acetabulum
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摘要 [目的]提出一种髋臼后柱顺行螺钉置入新的参考方法和相关解剖学参数,为后期导板设计提供基础。[方法]收集40例成人骨盆CT数据,通过Mimics软件重建三维模型。从髂翼内侧顺行置入一圆柱体通过后柱,调整到理想位置,该圆柱体从髂翼内侧的穿入点(A)作为拉力螺钉的入钉点,从坐骨结节下方的穿出点(B)作为拉力螺钉的出钉点。在弓状缘上取点C,使AC为入钉点到弓状缘的最短距离,D点为骶髂关节最前缘,连接AC和CD。在Mimics上找到方形区靠近坐骨大切迹后缘的一块较平整的区域,做一平面β平行于此区域,再做一平面γ垂直于平面β并与坐骨大切迹后缘相切。测量AC,CD的距离、拉力螺钉的最大半径和长度、拉力螺钉与平面β的夹角(a)及与平面γ的夹角(b)。[结果]在同一侧别男性与女性比较中,男性的螺钉最大半径和最大长度大于女性,线段CD小于女性,差异均有统计学意义(P<0.05);线段AC、夹角a和夹角b差异无统计学意义(P>0.05)。在同一性别左侧和右侧比较中,螺钉的最大半径、最大长度、线段AC、CD、夹角a和b差异均无统计学意义(P>0.05)。[结论]根据相关解剖学数据,使置钉过程更加精准安全,并为后期导板设计提供基础。 [Objective]To propose a new reference method and related anatomical parameters for anterograde screw placement in the posterior column of the acetabulum,and to provide a basis for the design of the 3D printed guider.[Methods]The CT data of 40 adult pelvis were collected and three-dimensional(3D)models were reconstructed by Mimics software.A cylinder was placed from the inner side of the iliac wing reaching to the posterior column and adjusted to the ideal position.The insertion point of the cylinder of the inner side of the iliac wing(A point)was set as the insertion point of the lag screw,whereas ischial tuberosity(B point)represented exiting point of lag screw.The C point was marked on the arcuate edge,which was the shortest distance to the arcuate edge from A point.In addition,the D point was marked on the most front of sacroiliac,and then the A point and C point,as well as the C point and the D point were connected.A flat square region near the posterior edge of the greater sciatic notch was found on mimics,a planeβwas made parallel to this region,and a planeγwas made perpendicular to and tangent to the posterior edge of the greater sciatic notch.The distance between AC and CD,which represented the maximum radius and length of lag screw,as well as the angle between lag screw and planeβ(a)and the angle between lag screw and planeγ(b)were measured.[Results]In term of gender,the males had the maximum radius and length of the screw significantly greater than the females(P<0.05),whereas the males had significantly shorter CD segment than females(P<0.05).However,there were no significant differences in terms of AC segment and angle a and angle b between the two genders(P>0.05).In term of bilateral sides,there were no statistically significant differences in the maximum radius,maximum length,AC segment,CD segment,and angle a and angle b between the left and right sides(P>0.05).[Conclusion]According to the relevant anatomical data,the screw placement process will be more accurate and safe,which provides a basis for the design of 3D printed guider later.
作者 叶厚龙 郑刘杰 荆珏华 韩志伟 冯茹 钟齐刚 姚强 姚运峰 YE Hou-long;ZHENG Liu-je;JING Yu-hua;HAN Zhi-wei;FENG Ru;ZHONG Qi-gang;YAO Qiang;YAO Yun-feng(Department of Orthopedics,The Second Affiliated Hospital,Anhui MedicalUniversity,Hefei 230601,China)
出处 《中国矫形外科杂志》 CAS CSCD 北大核心 2022年第16期1503-1507,共5页 Orthopedic Journal of China
关键词 髋臼 方形区 拉力螺钉 三维成像 影像解剖学 acetabulum quadrilateral region lag screw 3D image radiographic anatomy
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