| 骶髂关节螺钉固定应用及CT与解剖学研究 |
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Received:April 03, 2003
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| 作者 | Author | 单位 | Unit | E-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,Second Affiliated Hospital,Medical College of Zhejiang University |
honghuax ing@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,Second Affiliated Hospital,Medical College of Zhejiang University |
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| 黄宗坚 |
HUANG Zong-jian |
浙江大学医学院附属第二医院骨科, 浙江杭州310009 |
Department of Orthopaedics,Second Affiliated Hospital,Medical College of Zhejiang University |
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| 郑强 |
ZHENG Qiang |
浙江大学医学院附属第二医院骨科, 浙江杭州310009 |
Department of Orthopaedics,Second Affiliated Hospital,Medical College of Zhejiang University |
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| 期刊信息：《中国骨伤》2004年17卷，第5期，第270-273页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:采用CT扫描测量髂骨翼后外侧面至第1骶椎(S1)的距离和S1椎弓根宽,为临床上经骶髂关节螺钉固定治疗后骨盆环不稳定提供参考。
方法:对22例中国成人的骨盆标本共44侧骶髂关节进行CT和解剖学研究,测量S1椎弓根宽,髂骨翼后外侧面的进针点至S1椎弓根中心距离,进针点至S1椎体对侧前皮质距离,并对解剖测量值和CT测量值进行比较。在实验研究的基础上,对11例垂直不稳定后骨盆环骨折进行骶髂螺钉固定。
结果:髂骨翼后外侧面的进针点至椎弓根中心距离解剖和CT测量值分别为495±40mm和492±39mm,两者差异无显著性(P>0.05);进针点至S1椎体对侧前皮质距离解剖和CT测量值分别为869±46mm和864±44mm,两者差异无显著性(P>0.05);S1椎弓根宽解剖和CT测量值分别为277±20mm和207±25mm,两者差异有显著性(P<0.01)。临床11例共13枚骶髂螺钉均准确置入,无骨皮质穿破或神经血管损伤等并发症。
结论:术前CT扫描可准确地推算骶髂螺钉长度,具有临床实用意义。 |
| [关键词]:骶髂关节 骨折固定术,内 计算机断层摄影术,X线 |
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| Anatomical and computer tomographical study of the lag screw fixation of the sacroiliac joint |
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Abstract:
Objective:To measure the distance from entry point on the posterolateral ilium to the first sacral vertebra(S1)and the width of pedicle of S1,according to computer tomographical scan.
Methods:22 pelvis specimens of native adults were studied,for a total of 44 sacroiliac joint.Spiral computer tomography was used to scan 22 pelvis specimens.The distance from entry point on the posterolateral ilium to the center of pedicle of S1,the distance from entry point to contrary anterior cortex of S1 and the width of pedicle of S1 were measured on axial computer tomography scans.Then,anatomical measurement were performed on 22 cadaveric pelvis to determine the distance from enrty point on the posterolateral ilium to the center of pedicle of S1,the distance from entry point to contrary anterior cortex of S1 and the broad of pedicle of S1.11 patients with unstable posterior pelvic fractures were treated with iliosacral screw on the basis of this study.
Results:The distance from entry point on the posterolateral ilium to contrary anterior cortex of S1 measured by anatomical measurement and computer tomography scan were 86.9±4.6 mm and 86.4±4.4 mm respectively.The distance from entry point on the posterolateral ilium to the center of pedicle of S1 measured by anatomical measurement and computer tomography scan were 49.5±4.0 mm and 49.2±3.9 mm respectively.There was no significant difference between the results of anatomical measurement and computer tomography scan(P>0.05).The width of pedicle of S1 measured by anatomical measurement and computer tomography scan were 27.7±2.0 mm and 20.7±2.5 mm respectively.There was significant difference between the results of anatomical measurement and computer tomography scan(P<0.01).11 patients with posterior pelvic fractures fixation with 13 iliosacral screws,there was no screw penetrating pedicle of S1 or sacral vertebral body.Conclusions:The length of iliosacral screw can be accurately obtained from computer tomography scan.It is a safe and easy way for orthopaedist to select the length of scrw. |
| KEYWORDS:Sacroiliac joint Fracture fixation,internal Computerized tomography,X-ray |
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| 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,黄宗坚,郑强.骶髂关节螺钉固定应用及CT与解剖学研究[J].中国骨伤,2004,17(5):270~273 |
| 英文格式: | HONG Hua-xing,PAN Zhi-jun,HUANG Zong-jian,ZHENG Qiang.Anatomical and computer tomographical study of the lag screw fixation of the sacroiliac joint[J].zhongguo gu shang / China J Orthop Trauma ,2004,17(5):270~273 |
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