中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (39): 7232-7236.doi: 10.3969/j.issn.2095-4344.2012.39.003

• 骨科植入物 orthopedic implant • 上一篇    下一篇

钢板置入内固定髋臼后柱骨折中螺钉的最佳进钉点

王先泉1,周 伟2,张 伟1,王 健1,邢子英3,孙成良1,张进禄1,孙 水1,李 伟1   

  1. 1山东大学附属省立医院骨关节外科,山东省济南市 250021
    2邹城市红十字会急救中心,山东省邹城市 273500
    3山东大学医学院解剖学教研室,山东省济南市 250012
  • 收稿日期:2012-01-04 修回日期:2012-02-27 出版日期:2012-09-23 发布日期:2012-09-23
  • 作者简介:王先泉☆,男,1972 年生,山东省无棣县人,汉族,2005 年山东大学医学院毕业,博士,副主任医师,主要从事关节外科和创伤骨科研究。 wxq72@126.com

Optimal entry points of screw in internal fixation of acetabular posterior column fracture with plate

Wang Xian-quan1, Zhou Wei2, Zhang Wei1, Wang Jian1, Xing Zi-ying3, Sun Cheng-liang1, Zhang Jin-lu1,Sun Shui1, Li Wei1   

  1. 1Department of Bone and Joint, Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
    2Red Cross First Aid Center of Zoucheng City, Zoucheng 273500, Shandong Province, China
    3Teaching and Research Section of Anatomy, Medical School of Shandong University, Jinan 250012, Shandong Province, China
  • Received:2012-01-04 Revised:2012-02-27 Online:2012-09-23 Published:2012-09-23
  • About author:Wang Xian-quan☆, M.D., Associate chief physician, Department of Bone and Joint, Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China wxq72@126.com

摘要:

背景:骨盆骨折和髋臼骨折切开复位内固定过程中有时会发生螺钉穿入关节内、损伤盆腔内重要血管或神经等严重并发症。
目的:探讨髋臼后柱钢板内固定技术中螺钉的最佳进钉点、方向和长度。
方法:取成年男性半骨盆标本20个,制作髋臼后柱系列断面,测量各进钉点的螺钉进钉角度和长度。
结果与结论:各断面在髋臼缘、外中1/4点、中点、内中1/4点和髋臼后柱内缘的进钉安全角度分别为39°、57°、74°、90°和106°,螺钉长度分别为39,57,74,90和106 mm。在髋臼区的外1/4区、外中1/4区、内中1/4区和内1/4区,钉后柱角分别为40°-60°、60°-75°、75°-90°、90°-平行于四方区,螺钉长度30 mm。

关键词: 髋臼骨折, 内固定, 解剖, 后柱钢板, 螺钉, 进钉点, 植入体

Abstract:

BACKGROUND: Recently, open reduction and internal fixation has become a common therapy for pelvic and acetabular fractures. However, screw penetration sometimes damages important vessels or nerves in the pelvic cavity during the internal fixation.
OBJECTIVE: To investigate the optimal entry points, direction and length of screw in acetabular posterior column plate technique, and to prevent the serious complications caused by screw penetrating the joint surface.
METHODS: Twenty male cadaveric adult semipelvic specimens were taken and prepared into serial cross-sections of the acetabular posterior column. The safe angle of screw entry and the length on all entry points of each cross-section were measured. All data were input into software SPSS 10.0 for statistical process.
RESULTS AND CONCLUSION: On margin of acetabulum, lateral-middle 1/4 point, midpoint, medial-middle 1/4 point and medial margin of posterior column of each cross-section, safe entry angle of inclination was 39°, 57°, 74°, 90° and 106°respectively, the length of the screw was 39, 57, 74, 90 and 106 mm respectively. On lateral 1/4 region, lateral-middle 1/4 region, medial-middle 1/4 region and medial 1/4 region, screw posterior column angle was 40°-60°, 60°-75°, 75°-90°, 90°-parallel to the quadrilateral plate, and the length of the screw was 30 mm.

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