经皮逆行耻骨上支最大螺钉通道的数字解剖学研究

doi:10.13418/j.issn.1001-165x.2024.6.06

中国临床解剖学杂志 ›› 2024, Vol. 42 ›› Issue (6): 644-648.doi: 10.13418/j.issn.1001-165x.2024.6.06

经皮逆行耻骨上支最大螺钉通道的数字解剖学研究

杨德猛¹，何金键²，张铭坤²，宋金行²，李少娟²，任天宁²，闫含笑²，胡振华²，
彭丹丹²，朱树亮²，侯力康²，韩木愚²，陈志国³*

1.萍乡市人民医院创伤中心，江西萍乡 337000； 2.新乡医学院，河南新乡 453000；
3.新乡医学院基础医学院，河南新乡 453000

收稿日期:2024-01-17 出版日期:2024-11-25 发布日期:2024-12-16
通讯作者: 陈志国，博士，讲师，E-mail:czgxxmu@126.com
作者简介:杨德猛（1986-），男，江西萍乡市人，硕士，副主任医师，主要从事创伤骨科方向，E-mail:wanfengyang@163.com
基金资助:
江西省卫生健康委计划（SKJP202212188）

Digital anatomical research on the maximum screw channel of the percutaneous retrograde suprapubic branch

Yang Demeng¹, He Jinjian², Zhang Mingkun², Song Jinhang², Li Shaojuan², Ren Tianning², Yan Hanxiao², Hu Zhenhua², Peng Dandan², Zhu Shuliang², Hou Likang², Han Muyu², Chen Zhiguo³*

1. Trauma Center, Pingxiang People's Hospital, Pingxiang 337000, China; 2. Xinxiang Medical University, Xinxiang 453000, China; 3. Basic Medical College, Xinxiang Medical University, Xinxiang 453000, China

Received:2024-01-17 Online:2024-11-25 Published:2024-12-16

摘要/Abstract

摘要： 目的建立骨盆3D模型，模拟耻骨上支螺钉置入过程，确定逆行耻骨上支螺钉置入最大通道的参数。方法收集萍乡市人民医院影像中心2020年12月~2023年1月成年人骨盆CT扫描数据50例,导入Mimics 20.0软件，重建骨盆3D模型并模拟螺钉置入。置入流程如下：（1）确定耻骨上支螺钉通道的轴线，置入小直径虚拟圆柱；（2）增加虚拟圆柱的直径，直至其恰不突破耻骨体、耻骨上支及髋臼为止，视其为最大螺钉通道；（3）测量最大螺钉通道的长度、直径，螺钉轴线与矢状面和横断面的角度。结果最大通道长度范围：男性右侧（107.26±7.58） mm、男性左侧（106.96±11.01） mm、女性右侧（102.34±8.30） mm、女性左侧（103.30±10.05） mm；最大通道直径范围：男性右侧（8.10 ± 0.61） mm、男性左侧（8.05±0.66） mm、女性右侧(6.57±0.77) mm、女性左侧（6.48±0.61）螺钉通道最大长度和与横断面夹角在性别和左右侧别间差异无统计学意义（P>0.05）；最大直径在左右侧别间差异无统计学意义（P>0.05）。在男女性别间差异有统计学意义（P<0.001）。结论男性最大螺钉通道的平均直径为8.07 mm，平均长度107.11 mm；女性平均为6.50 mm，平均长度为102.82 mm。本研究可为经皮逆行耻骨上支通道螺钉固定耻骨上支骨折提供解剖学参考。

关键词: 耻骨上支骨折, , , 逆行耻骨上支螺钉, , , 数字解剖

Abstract: Objective To construct a 3D model of the pelvis, simulate the process of suprapubic screw placement, and determine the parameters of the largest channel for retrograde suprapubic screw placement. Methods Pelvic CT scan data of 50 adults were collected from the Imaging Center of Pingxiang People's Hospital from December 2020 to December 2022. This data was imported into Mimics 20.0 software to reconstruct the 3D pelvic model and simulate screw placement. The placement process was as follows: (1) The axis of the suprapubic screw channel was determined, a small-diameter virtual cylinder was inserted; (2) The diameter of the virtual cylinder was increased until it didn't break through the pubic body, suprapubic ramus and acetabulum, considering it as the largest screw channel; (3) The length and diameter of the largest screw channel, the angle of the screw axis with the sagittal and transverse planes were measured. Results The ranges of the largest channel length were: male right (107.26±7.58) mm, male left (106.96±11.01) mm, female right (102.34±8.30) mm, female left (103.30±10.05) mm; the range of largest channel diameter were: male right (8.10±0.61) mm, male left (8.05±0.66) mm, female right (6.57±0.77) mm, female left (6.48±0.61) mm. There was no significant difference in the maximum length of the screw channel and the included angle with the cross section between male and female and between the left and right sides (P>0.05). There was no significant difference in the maximum diameter between the left and right sides (P>0.05), but the difference between male and female was statistically significant (P<0.001). Conclusions The average diameter and length of male in maximum screw channel are 8.07 mm and 107.11 mm, respectively. The average diameter and length of female are 6.50 mm 102.82 mm, respectively. This study can provide anatomical reference for percutaneous retrograde suprapubic branch screw fixation and help clinicians choose suitable surgical screws.

Key words: Superior pubic ramus fracture, , , Retrograde superior pubic ramus screw, , , Digital anatomy

中图分类号:

R323.45

杨德猛, 何金键, 张铭坤, 宋金行, 李少娟, 任天宁, 闫含笑, 胡振华, 彭丹丹, 朱树亮, 侯力康, 韩木愚, 陈志国. 经皮逆行耻骨上支最大螺钉通道的数字解剖学研究[J]. 中国临床解剖学杂志, 2024, 42(6): 644-648.

Yang Demeng, He Jinjian, Zhang Mingkun, Song Jinhang, Li Shaojuan, Ren Tianning, Yan Hanxiao, Hu Zhenhua, Peng Dandan, Zhu Shuliang, Hou Likang, Han Muyu, Chen Zhiguo. Digital anatomical research on the maximum screw channel of the percutaneous retrograde suprapubic branch[J]. Chinese Journal of Clinical Anatomy, 2024, 42(6): 644-648.

参考文献

[1] 袁欣华, 吴乃庆, 庞清江, 等. 逆行耻骨上支髓内螺钉固定应用解剖研究[J]. 中国骨与关节损伤杂志, 2006, 21(7): 539-541. DOI:10.3969/j.issn.1672-9935.2006.07.013.
[2] Mouhsine E, Garofalo R, Borens O, et al. Percutaneous retrograde screwing for stabilisation of acetabular fractures[J].Injury, 2005, 36(11):1330-1336. DOI: 10.1016/j.injury.2004.09.016.
[3] 蒋巍, 张云坤, 徐南伟, 等. 骶髂关节脱位并耻骨联合分离、骨折的手术治疗 [J]. 医学临床研究, 2008, 25(5): 802-805 DOI: 10.3969/j.issn.1671-7171.2008.05.011.
[4] Ye P, Lihai Z,William M, et al. Comparison of anterograde versus retrograde percutaneous screw fixation of anterior column acetabular fractures[J]. Int J Comput Assist Radiol Surg, 2016, 11(4):635-639.DOI：10.1007/s11548-015-1308-9.
[5] Maria PR, Daniel W, Alex H. Minimal invasive surgical treatment of fragility fractures of the pelvis[J].Chirurgia (Bucur),2017,112(5):524-537.DOI：10.21614/chirurgia.112.5.524.
[6] 杨勇, 王磊, 王福川, 等. 耻骨上支骨折髓内螺钉进钉通道的数字解剖学研究[J].中国临床解剖学杂志, 2013, 31(4):397-401. DOI: 10.7666/d.y2104949.
[7] Ochs GB, Stuby MF, Ateschrang A,et al. Retrograde lag screw placement in anterior acetabular column with regard to the anterior pelvic plane and midsagittal plane-Virtual mapping of 260 three-dimensional hemipelvises for quantitative anatomic analysis[J].Injury, 2014, 45(10):1590-1598. DOI：10.1016/j.injury.2014.06.026.
[8] Pijun Z, Jie T, Yonghui D, et al. A new navigational apparatus for fixation of acetabular posterior column fractures with percutaneous retrograde lagscrew: Design and application[J].Medicine, 2018,97(36):e12134. DOI：10.1097/MD.0000000000012134.
[9] Him KC, Dennis CCC, Chun KI , et al. Three-dimensional navigation-guided percutaneous screw fixation for nondisplaced and displaced pelvi-acetabular fractures in a major trauma centre[J]. Int Orthop,2018,42(6):1387-1395. DOI：10.1007/s00264-017-3659-z.
[10]Theologis AA, Burch S, Pekmezci M. Placement of iliosacral screws using 3D image-guided (O-Arm) technology and Stealth Navigation: comparison with traditional fluoroscopy[J]. Bone Joint J, 2016, 98-B(5): 696-702. DOI：10.1302/0301-620X.98B5.36287
[11]Richter P, Gebhard F, Dehner C, et al. Accuracy of computer-assisted iliosacral screw placement using a hybrid operating room[J].Injury, 2016, 47(2):402-407. DOI：10.1016/j.injury.2015.11.023
[12]杨德猛, 霍念慈, 周奥然, 等. 逆行耻骨上支通道螺钉两种入针点与生殖结构距离的解剖研究 [J]. 中国临床解剖学杂志, 2023, 41(2): 121-127. DOI:10.13418/j.issn.1001-165x.2023.2.01.
[13]Routt ML Jr, Simonian PT, Grujic L. The retrograde medullary superior pubic ramus screw for the treatment of anterior pelvic ring disruptions: a new technique[J]. Orthop Trauma, 1995, 9(1):35-44. DOI:10.1097/00005131-199502000-00006.
[14]Attias N, Lindsey WR , Starr JA, et al. The use of a virtual three-dimensional model to evaluate the intraosseous space available for percutaneous screw fixation of acetabular fractures[J]. J Bone Joint Surg Br, 2005, 87(11):1520-1523. DOI:10.1302/0301-620X.87B11.16614.
[15]Shahulhameed A, Roberts SC, Pomeroy LC, et al. Mapping the columns of the acetabulum-Implications for percutaneous fixation[J].Injury, 2009, 41(4): 339-342. DOI:10.1016/j.injury.2009.08.004.
[16]Feng X, Feng J, Lin C, et al. Axial perspective to find the largest intraosseous space available for percutaneous screw fixation of fractures of the acetabular anterior column[J].Int J Comput Assist Radiol Surg, 2015, 10(8):1347-1353.DOI:10.1007/s11548-015-1149-6.
[17]Vivek T, Arvind K, Samarth M, et al. Morphometric analysis of the anterior column of the acetabulum and safety of intramedullary screw fixation for its fractures in Indian population: a preliminary report[J]. Int Orthop, 2020, 44(4): 655-664.DOI:10.1007/s00264-019-04428-5.

经皮逆行耻骨上支最大螺钉通道的数字解剖学研究

Digital anatomical research on the maximum screw channel of the percutaneous retrograde suprapubic branch

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