经S2椎弓根骶髂关节螺钉固定CT和解剖学研究
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作者Author单位AddressE-Mail
洪华兴 HONG Hua-xing 浙江大学医学院附属第二医院骨科, 浙江杭州310009 Department of Orthopaedics,the Second Affiliated Hospital of Medical College of Zhejiang University honghuaxing@sohu.com 
潘志军 PAN Zhi-jun 浙江大学医学院附属第二医院骨科, 浙江杭州310009 Department of Orthopaedics,the Second Affiliated Hospital of Medical College of Zhejiang University  
陈欣 CHEN Xin 浙江大学医学院附属第二医院骨科, 浙江杭州310009 Department of Orthopaedics,the Second Affiliated Hospital of Medical College of Zhejiang University  
徐刚 XU Gang 浙江大学医学院附属第二医院骨科, 浙江杭州310009 Department of Orthopaedics,the Second Affiliated Hospital of Medical College of Zhejiang University  
期刊信息:《中国骨伤》2004年,第17卷,第9期,第527-530页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:为经S2椎弓根水平骶髂关节螺钉固定提供解剖学依据。

方法:对22个骨盆标本进行解剖学研究,测量经S2椎弓根骶髂关节螺钉固定的进针点、进针方向、钉道直径、进针点至S2椎体中心和椎弓根中心距离、S2椎弓根横断面形状。

结果:螺钉进针点在髂后下棘前方28.7mm(150~345mm),坐骨切迹上方15.3mm(100~220mm);进针方向垂直于正中矢状面且与髂骨翼外侧面夹角为62.4°(55°~72°);钉道直径为11.5mm(8.5~14.0mm);进针点至S2椎体中心距离64.7mm(55.3~77.6mm);进针点至S2椎弓根中心距离为53.1mm(45.3~64.8mm);S2椎弓根横截面呈三角形。

结论:经S2椎弓根水平骶髂关节螺钉固定的进针点应位于髂后下棘前方30mm,坐骨切迹上方15mm;进针方向垂直于正中矢状面且与髂骨翼外侧面夹角为60°;S2椎弓根钉道直径较小,经S2椎弓根水平骶髂关节螺钉固定应选择直径较小的短螺钉。
【关键词】骶髂关节  骨折固定术,内  解剖学
 
Anatomical and computer tomographical study of the parameters of lag screw fixation of the sacroiliac joint through S2 pedicle
ABSTRACT  

Objective:To provide the anatomic basis for sacroiliac screw fixation through S2 pedicle.

Methods:Twenty-two pelvis specimens of native adults were studied.Spiral CT was used to scan 22 pelvis specimens.The axis of S2 pedicle and the direction of sacroiliac screw were studied on axial CT scans.Then,anthropometric measurement were performed on 22 cadaveric pelvis to determine the optimal entry point for sacroiliac screw on the outer table of ilium,the direction of sacroiliac screw,the diameter of the sacroiliac screw path,the distance from entry point to the center of S2 vertebral body,the distance from entry point to the center of S2 pedicle,and the shape of the S2 pedicle transverse section.

Results:The average entry point for screw fixation on the outer table of ilium located 28.7 mm(15.0~34.5 mm) anterior to posterior inferior iliac spine and 15.3 mm(10.0~22.0 mm) superior to the sciatic notch.The direction of screw was perpendicular to midsagittal plane.The angle between the direction of screw and the outer table of ilium was 62.4°(55°~72°).The diameter of the sacroiliac screw path,the distance from entry point to the center of S2 vertebral body and the distance from the entry point to the center of S2 pedicle were 11.5 mm(8.5~14.0 mm),64.7 mm(55.3~77.6 mm) and 53.1 mm(45.3~64.8 mm) respectively.The shape of S2 pedicle transverse section was triangle.

Conclusion:The entry point locates 30 mm anterior to posterior inferior iliac spine and 15 mm superior to the sciatic notch.The direction of sacroiliac screw perpendicular to midsagittal plane.The angle between the direction of screw and the outer talble of ilium is 60°.The diameter of sacroiliac screw path through S2 pedicle smaller than that of sacroiliac screw path through S1 pedicle.Sacroiliac screw fixation for sacroiliac joint through S2 pedicle should use the smaller diameter and shorter screw.
KEY WORDS  Sacroiliac joint  Fracture fixation,internal  Anatomy
 
引用本文,请按以下格式著录参考文献:
中文格式:洪华兴,潘志军,陈欣,徐刚.经S2椎弓根骶髂关节螺钉固定CT和解剖学研究[J].中国骨伤,2004,17(9):527~530
英文格式:HONG Hua-xing,PAN Zhi-jun,CHEN Xin,XU Gang.Anatomical and computer tomographical study of the parameters of lag screw fixation of the sacroiliac joint through S2 pedicle[J].zhongguo gu shang / China J Orthop Trauma ,2004,17(9):527~530
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