基于三维建模的髋臼前入路置钉安全区域测量

Measurement of the acetabular screw safety zone in anterior approach based on three-dimensional modeling

目的 通过构建骨盆髋臼前入路置钉三维模型,测量髋臼周围安全区域解剖数据,为安全置钉提供参考。方法 选取2022年10月至2023年5月在郴州市第一人民医院体检的健康成人完整骨盆图像数据40例,其中男22例,女18例。运用E3D和Geomagic wrap软件重建骨盆髋臼三维立体模型,以髂耻隆起为基点,测量髋臼周围前入路置钉危险区、相对安全区和安全区。结果 以髂耻隆起为基点,前方小于(8.57±2.60) mm的区域,后方小于(7.80±2.19) mm的区域为髋臼周围危险区,置钉时易穿入髋关节,应避开该区域置钉;前方(8.57±2.60)~(19.87±2.92) mm的区域和后方(7.80±2.19)~(19.98±2.66) mm的区域为相对安全区,以远离髋臼的最大偏转角置钉,螺钉不会穿入髋臼;前方大于(19.87±2.92) mm和后方大于(19.98±2.66) mm的区域为安全区,以远离髋臼的角度可安全置钉。安全置钉最大长度前方为(32.88±5.25) mm,后方为(42.90±5.55) mm。结论 E3D联合Geomagic Wrap软件可精准构建骨盆髋臼三维立体模型,通过测量模型相关数据,获得前入路置钉的相关解剖学参数,为临床精准置钉提供参考。

Objective To measure the anatomical data of the safe area around the acetabulum by constructing a three-dimensional model of the pelvis and acetabulum through the anterior approach for screw placement,and to provide reference for safe screw placement.Methods Forty complete pelvic image data of healthy adults(22 males and 18 females)who underwent physical examination in the First People s Hospital of Chenzhou from October 2022 to May 2023 were selected.E3D combined with Geomagic Wrap software was used to reconstruct the three-dimensional model of the pelvis and acetabulum.Based on the iliopubic eminence,the risk area,relative safe area,and safe area of periacetabular screw placement were measured.Results The iliopubic eminence was used as the base point.The area less than(8.57±2.60)mm in the anterior area and(7.80±2.19)mm in the posterior area was the periacetabular risk zone,which was easy to penetrate the hip joint during screw insertion,and should be avoided.The area between the anterior(8.57±2.60)mm and(19.87±2.92)mm and the area between the posterior(7.80±2.19)mm and(19.98±2.66)mm was the relatively safe area.The screw was placed at the maximum deflection angle away from the acetabulum,and the screw would not penetrate into the acetabulum.The safe zone was(19.87±2.92)mm in the anterior and(19.98±2.66)mm in the posterior,and the screw was placed safely away from the acetabulum.The maximum length of the safety screw was(32.88±5.25)mm in the anterior and(42.90±5.55)mm in the posterior.Conclusions E3D combined with Geomagic Wrap software can accurately construct a three-dimensional model of the pelvis and acetabulum.The model data measurement can provide reference for precise clinical screw placement.