Du Xingye, Liu Yong, Jiang Xuefeng
Department of Orthopedics, Affiliated Jiangyin Hospital of Nantong University, Jiangyin, China.
Orthop Surg. 2025 May;17(5):1454-1463. doi: 10.1111/os.70011. Epub 2025 Mar 18.
Lateral compression II (LC-II) fractures, a common type of pelvic injury, often require closed reduction and percutaneous screw fixation due to posterior pelvic ring instability. However, existing methods fail to adequately account for the internal structure of the screw path and lack precise anatomical guidance, increasing surgical risks. This study utilized digital medical software to analyze the LC-II screw path and entry parameters, providing the anatomical references.
This retrospective study enrolled 43 adult patients (21 males and 22 females) who underwent a complete computed tomography (CT) scan examination from February 2017 to February 2019. The digital three-dimensional (3D) pelvic model was reconstructed, and the ideal LC-II screw path was designed by the cross-section method. The primary evaluation parameters included the screw path length (D ), maximum diameter (D ), distances at narrow points (D1 and D2), bone thickness parameters (OW1 and IW1; OW2 and IW2), and screw entry angles (∠α, ∠β, ∠γ).
Of 43 patients, 42 successfully completed LC-II screw path construction. Among 21 female patients, 5 (23.8%) could accommodate screws with a maximum diameter of < 6.5 mm. Compared with female patients, male patients exhibited significantly higher D , D , D , OW, IW, IW/OW, and IW/OW (p < 0.05). The ∠γ was significantly lower in male patients. Furthermore, digital 3D pelvic model observations revealed that LC-II screws bone entry points in the anterior iliac region were all located posterior to the anterior inferior iliac spine (AIIS). The angles between the LC-II screw and coronal plane were 48.06° in males and 45.10° in females, while the angles between the LC-II screw and sagittal plane were 27.14° and 25.60°, respectively.
This study utilized digital medical software to construct the LC-II screw path and analyze sex-based differences, highlighting the importance of individualized preoperative path planning and providing essential anatomical evidence for the precise and safe percutaneous insertion of LC-II screws.
侧方挤压II型（LC-II）骨折是骨盆损伤的常见类型，由于骨盆后环不稳定，常需进行闭合复位和经皮螺钉固定。然而，现有方法未能充分考虑螺钉路径的内部结构，缺乏精确的解剖学指导，增加了手术风险。本研究利用数字医学软件分析LC-II螺钉路径和进针参数，提供解剖学参考。
本回顾性研究纳入了2017年2月至2019年2月期间接受完整计算机断层扫描（CT）检查的43例成年患者（21例男性和22例女性）。重建数字三维（3D）骨盆模型，采用横断面法设计理想的LC-II螺钉路径。主要评估参数包括螺钉路径长度（D）、最大直径（D）、狭窄点距离（D1和D2）、骨厚度参数（OW1和IW1；OW2和IW2）以及螺钉进针角度（∠α、∠β、∠γ）。
43例患者中，42例成功完成LC-II螺钉路径构建。在21例女性患者中，5例（23.8%）可容纳最大直径<6.5mm的螺钉。与女性患者相比，男性患者的D、D、D、OW、IW、IW/OW和IW/OW显著更高（p<0.05）。男性患者的∠γ显著更低。此外，数字3D骨盆模型观察显示，LC-II螺钉在髂前区域的骨质进针点均位于髂前下棘（AIIS）后方。LC-II螺钉与冠状面的夹角男性为48.06°，女性为45.10°，与矢状面的夹角分别为27.14°和25.60°。
本研究利用数字医学软件构建LC-II螺钉路径并分析性别差异，突出了个体化术前路径规划的重要性，为LC-II螺钉的精确安全经皮置入提供了重要的解剖学依据。
