Baumann Florian, Schmitz Paul, Mahr Daniel, Kerschbaum Maximilian, Gänsslen Axel, Nerlich Michael, Worlicek Michael
Department of Trauma Surgery, Regensburg University Medical Center, 93042, Regensburg, Germany.
Clinic for Trauma Surgery, Orthopedics and Hand Surgery, Klinikum Wolfsburg, Wolfsburg, Germany.
J Orthop Surg Res. 2018 Apr 10;13(1):77. doi: 10.1186/s13018-018-0786-1.
Due to demographic changes, more and more fracture patterns involving anterior acetabular structures occur. The infra-acetabular screw is seen a useful tool to increase stability in fixation of the acetabular cup. However, the exact position of this screw in relation to anatomic landmarks which are intra-operatively palpable via an intra-pelvic approach has not yet been determined.
This biomorphometric experimental study references the ideal screw position of an infra-acetabular screw to anatomic landmarks palpable via an intra-pelvic approach. Therefore, we created a computer tomography-based 3D-model of 40 patients (20 women, 20 men) who received a computer tomography (CT) scan of the pelvis for any other reason than an acetabular fracture.
The entry point of an ideal infra-acetabular was of high constancy. At mean, this point was 10.2 mm caudal and 10.4 mm medial of the ilio-pubic/ilio-pectineal eminence. This reference is independent of age, gender, or physical dimensions. However, we found gender-dependent differences for the angulation and the length of the screw.
This study provides a comprehensive guideline to determine the ideal entry point for an infra-acetabular screw via an intra-pelvic approach. The entry point is located 10.2 mm caudal and 10.4 mm medial of the ilio-pubic/ilio-pectineal eminence.
Clinical Trial Registry University of Regensburg Z-2017-0930-1 . Registered 04. Dec 2017.
由于人口结构变化，涉及髋臼前部结构的骨折模式越来越多。髋臼下螺钉被视为增加髋臼杯固定稳定性的有用工具。然而，该螺钉相对于通过盆腔内入路在术中可触及的解剖标志的确切位置尚未确定。
本生物形态计量学实验研究将髋臼下螺钉的理想螺钉位置与通过盆腔内入路可触及的解剖标志相关联。因此，我们创建了40例患者（20名女性，20名男性）基于计算机断层扫描的三维模型，这些患者因髋臼骨折以外的任何原因接受了骨盆计算机断层扫描（CT）。
理想髋臼下螺钉的进针点具有高度一致性。平均而言，该点位于髂耻/髂耻隆起尾侧10.2毫米和内侧10.4毫米处。该参考值与年龄、性别或身体尺寸无关。然而，我们发现螺钉的角度和长度存在性别差异。
本研究提供了一份综合指南，以确定通过盆腔内入路置入髋臼下螺钉的理想进针点。进针点位于髂耻/髂耻隆起尾侧10.2毫米和内侧10.4毫米处。
雷根斯堡大学临床试验注册中心Z-2017-0930-1。2017年12月4日注册。
