Ji Xiaoxi, Bi Chun, Wang Fang, Jiang Yuchen, Wang Dongmei, Wang Qiugen
Trauma Center, Shanghai First People's Hospital, Shanghai Jiao Tong University, 650 xinsongjiang Rd, Songjiang District, Shanghai, 201620, China.
School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China.
BMC Musculoskelet Disord. 2015 Mar 15;16:55. doi: 10.1186/s12891-015-0518-1.
Screw penetration into hip joint is a severe complication during acetabular fracture surgery, which might result in osteoarthritis and chondrolysis. The purpose of this study was to obtain the safe and effective screw angles and lengths at acetabular area of the fixation route along the superior border of the arcuate line.
A total of 98 uninjured pelvises of Chinese adults were examined. Each person's computed tomography (CT) scans were reconstructed to create a three-dimensional pelvic model. A curve of the fixation route was delineated and five cross-sections from the pubic tubercle to the sacroiliac joint direction were constructed perpendicularly to the curve. The minimum safe direction, which was tangent to the acetabulum, was measured in the middle three sections and then recorded as the angle α. The maximum effective direction, which was determined by a 14 mm arc and the quadrilateral surface, was also measured in the above sections and then recorded as the angle β. The maximum screw lengths for the five sections were measured.
The ranges of safe and effective screw insertion angles for the 2nd, 3rd, 4th cross-sections were 21.09±13.57°40.45±13.60°, 30.43±14.05°47.54±12.67°, 23.84±11.60°~37.13±8.45°, respectively. The maximum screw lengths for the five sections were 15.89±3.80 mm, 58.83±27.66 mm, 42.94±22.41 mm, 72.43±6.73 mm, 40.99±6.33 mm. The male group showed significantly greater minimum safe angle compared to the female group in the 2nd, 3rd, and 4th sections (p<0.05).
The screw insertion at the acetabular area for the female requires greater minimum safe angle towards the quadrilateral surface than the male.
髋臼骨折手术中螺钉穿入髋关节是一种严重并发症，可能导致骨关节炎和软骨溶解。本研究的目的是获取沿弓状线 上缘固定路径在髋臼区域的安全有效螺钉角度和长度。
对 98 例中国成年未受伤骨盆进行检查。将每个人的计算机断层扫描（CT）图像重建以创建三维骨盆模型。描绘出固定路径曲线，并垂直于该曲线构建从耻骨结节到骶髂关节方向的五个横截面。在中间三个截面中测量与髋臼相切的最小安全方向，然后记录为角度α。在上述截面中还测量由 14 毫米弧和四边形表面确定的最大有效方向，然后记录为角度β。测量五个截面的最大螺钉长度。
第 2、3、4 个横截面的安全和有效螺钉插入角度范围分别为 21.09±13.57°至 40.45±13.60°、30.43±14.05°至 47.54±12.67°、23.84±11.60°至 37.13±8.45°。五个截面的最大螺钉长度分别为 15.89±3.80 毫米、58.83±27.66 毫米、42.94±22.41 毫米、72.43±6.73 毫米、40.99±6.33 毫米。在第 2、3 和 4 个截面中，男性组的最小安全角度明显大于女性组（p<0.05）。
女性在髋臼区域插入螺钉时，相对于男性需要更大的朝向四边形表面的最小安全角度。
