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髋臼后柱逆行拉力螺钉固定的定量解剖学基础。

Quantitative anatomic basis of antegrade lag screw placement in posterior column of acetabulum.

机构信息

Department of Orthopaedics, Provincial Hospital Affiliated to Shandong University, Jinan, China.

出版信息

Arch Orthop Trauma Surg. 2009 Nov;129(11):1531-7. doi: 10.1007/s00402-009-0836-6. Epub 2009 Feb 17.

Abstract

BACKGROUND

Lag screw fixation has been recommended for treatment of acetabular and pelvic fracture for several years. The aim of the present study was to determine the projection of the axis of the posterior column on the inner table of the iliac wing in the supra-acetabular region.

METHODS

Thirty adult dried bony hemipelves specimens and other five intact adult dried pelvic specimens were included in this study. The projection point of the axis of the posterior column of the acetabulum was determined on the inner table of the iliac wing of the hemipelves specimens. The perpendicular distance from the optimal entry point to the linea terminalis of pelvis was measured and recorded as the lateral distance. The same measurement along the linea terminalis from the optimal entry point to the junction between the anterior border of iliosacral articulation and the linea terminalis of pelvis was made and recorded as the posterior distance. The depth of the anchor path and the corresponding average retroversion angulation and extraversion angulation were also measured. According to the results acquired from this study, a series of 6.5 mm lag screws were inserted into the posterior column of each side of the other five intact specimens, respectively, to evaluate the position of the screws. The data were expressed as mean +/- SD and analyzed by using the descriptive methods with SPSS 10.0.

RESULTS

The average length of lag screw was 104.8 +/- 4.2 mm. The average lateral distance was 16.8 +/- 2.1 mm. The average posterior distance was 23.5 +/- 3.4 mm. The corresponding average retroversion angulation and extraversion angulation were 57 degrees 36' +/- 4 degrees 28' and 119 degrees 18' +/- 2 degrees 32', respectively. The insertion of the single 6.5 mm lag screw of adequate length was possible in the posterior column along its anchor path and no accidental extraosseous or intraarticular screw placement had occurred.

CONCLUSIONS

The present study describes a safe anchor path of antegrade lag screw fixation in the posterior column. Insertion of the lag screws of adequate length is possible in the posterior column along its functional axis.

摘要

背景

数年来,使用拉力螺钉固定治疗髋臼和骨盆骨折一直被推荐使用。本研究的目的在于确定髋臼后柱轴线在骨盆骼骨翼内板上的投影。

方法

本研究纳入 30 例成人干骺端骨盆标本和 5 例完整的成人干骺端骨盆标本。在干骺端骨盆标本的骼骨翼内板上确定髋臼后柱轴线的投影点。从最佳进钉点到骨盆骼嵴终末线的垂直距离被测量并记录为外侧距离。从最佳进钉点沿骨盆骼嵴终末线到荐骼关节前缘与骨盆骼嵴终末线交界处的距离被测量并记录为后侧距离。同时测量锚钉路径的深度以及相应的平均后倾角度和外展角度。根据本研究的结果,在另外 5 例完整标本的每侧后柱分别插入一系列 6.5mm 拉力螺钉,以评估螺钉的位置。数据用 SPSS 10.0 软件进行描述性分析,结果用均数±标准差表示。

结果

拉力螺钉的平均长度为 104.8±4.2mm。平均外侧距离为 16.8±2.1mm。平均后侧距离为 23.5±3.4mm。相应的平均后倾角度和外展角度分别为 57°36′±4°28′和 119°18′±2°32′。沿其锚钉路径,单枚合适长度的 6.5mm 拉力螺钉可安全地植入后柱,且无螺钉穿出皮质或进入关节内。

结论

本研究描述了一种安全的后柱逆行拉力螺钉固定的锚钉路径。沿后柱的功能轴线,可将合适长度的拉力螺钉安全地植入后柱。

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