Gänsslen Axel, Lindahl Jan, Lindtner Richard A, Krappinger Dietmar, Staresinic Mario
Department of Trauma Surgery, Hannover Medical School, Hanover, Germany.
Johannes Wesling Klinikum Minden, Minden, Germany.
Arch Orthop Trauma Surg. 2025 Jan 4;145(1):110. doi: 10.1007/s00402-024-05610-0.
Adequate intraoperative visualization is mandatory for implant application in pelvic ring injuries. Several fluoroscopic X-ray views are in practical use. The gold standard primary X-ray is the anteroposterior view of the pelvis. In addition to this view, oblique views for pelvic ring instabilities and acetabular fractures are well defined. Combinations of these views allow better identification of osseous corridors for screw applications. These corridors are based on the 3-ring concept of the hemipelvis. For pelvic ring stabilization the main osseous corridors include the retrograde and antegrade superior ramus/anterior column corridor, the supraacetabular corridor and the gluteus medius pillar corridor. The radiographic anatomy of these corridors is described in detail for screw applications with definition of image intensifier angulations, risk zones and corridor parameters. This allows for intraoperative safe implant application.
在骨盆环损伤中应用植入物时,术中充分的可视化是必不可少的。目前实际使用了几种荧光透视X线视图。金标准的主要X线视图是骨盆前后位视图。除了该视图外,用于骨盆环不稳定和髋臼骨折的斜位视图也有明确的定义。这些视图的组合有助于更好地识别用于螺钉置入的骨通道。这些通道基于半骨盆的三环概念。对于骨盆环稳定,主要的骨通道包括逆行和顺行的耻骨上支/前柱通道、髋臼上通道和臀中肌支柱通道。详细描述了这些通道的放射学解剖结构,用于螺钉置入,包括影像增强器角度、风险区域和通道参数的定义。这使得术中能够安全地应用植入物。