男性与女性髋臼下方螺钉置钉安全通道的数字解剖学比较研究
A digital anatomy study of the secure corridor for infra-acetabular screw placement
吕刚 1马超 1马志强 1买买艾力·玉山 1撒海明 1朱江 1吾依拉汗·托列吾汗 1黄异飞1
作者信息
- 1. 新疆维吾尔自治区中医医院骨一科,乌鲁木齐 830000
- 折叠
摘要
目的 建立国人骨盆与髋臼的数字解剖模型,比较男性与女性髋臼下方螺钉的置钉参数.方法 收集2018年1月至2021年12月期间新疆维吾尔自治区中医医院163例成年患者的正常骨盆CT数据.男61例,女102例;年龄53.0(45.0,60.0)岁.利用Mimics 21.0软件三维重建骨盆并导入Autodesk maya 2022软件将模型调平,利用多边形建模工具创建一个圆柱模拟髋臼下方螺钉并测量螺钉长度、角度;在Mimics 21.0软件中通过轴向透视法测量髋臼下方螺钉的直径.比较男性与女性髋臼下方骨通道的最大直径、最大长度,以及髋臼下方螺钉轴线与骨盆前平面、正中矢状面的夹角等.结果 男性左、右侧髋臼下方骨通道最大直径分别为5.24(4.26,6.38)、5.04(4.50,6.57)mm,女性分别为3.99(3.81,4.51)、3.89(3.65,4.90)mm;男性左、右侧髋臼下方骨通道最大长度分别为(98.43±4.42)、(98.01±5.08)mm,女性分别为 87.73(84.22,90.98)、87.51(84.59,90.15)mm;男性左、右侧髋臼下方螺钉轴线与正中矢状面夹角分别为-0.98°±4.79°、-1.08°±4.91°,女性分别为6.20°(3.34°,11.16°)、6.44°(3.77°,11.85°);以上数据男性与女性之间比较差异均有统计学意义(P＜0.05).男性与女性之间左、右侧髋臼下方螺钉轴线与骨盆前平面夹角比较差异均无统计学意义(P＞0.05).结论 男性髋臼下方骨通道的长度和直径均大于女性,与矢状面的夹角小于女性,男性钉道更加平行于矢状面,术中置入髋臼下方螺钉时应调整透视角度,以降低置钉难度.
Abstract
Objective To compare the parameters for infra-acetabular screw placement between men and women using a digital Chinese anatomical model of the pelvis and acetabulum.Methods The normal pelvic CT data were collected from the 163 adult patients who had been admitted to the Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2021.There were 61 males and 102 females with an age of 53.0(45.0,60.0)years.Mimics 21.0 software was used to reconstruct the three dimensional pelvis which was then imported into Autodesk maya 2022 software before the model was flattened.Polygonal modeling tools were used to create a cylinder to simulate an infra-acetabular screw for length and angle measurements of the screw.The diameters of the infra-acetabular screws were measured by ax-ial fluoroscopy in Mimics 21.0 software.The maximum diameters and maximum lengths of the in-fra-acetabular bone channel were compared between males and females,and the angles between the axis of the infra-acetabular screw and the anterior pelvic plane and the median sagittal plane were also compared be-tween genders.Results The maximum diameters of the left and right infra-acetabular corridors were 5.24(4.26,6.38)mm and 5.04(4.50,6.57)mm in males,and 3.99(3.81,4.51)mm and 3.89(3.65,4.90)mm in females;the maximum lengths of the left and right infra-acetabular corridors were(98.43± 4.42)mm and(98.01±5.08)mm in males and 87.73(84.22,90.98)mm and 87.51(84.59,90.15)mm in females.The left and right angles between the infra-acetabular screw axis and the median sagittal plane were-0.98°±4.79° and-1.08°±4.91° in men,and 6.20°(3.34°,11.16°)and 6.44°(3.77°,11.85°)in women.The differences in the above data between men and women were statistically significant(P＜0.05).There was no statistically significant difference between men and women in the angle between the in-fra-acetabular screw axis and the anterior pelvic plane(P＞0.05).Conclusions The length and diame-ter of the infra-acetabular corridor in males are greater than those in females,the angle between the in-fra-acetabular corridor and the sagittal plane in males is smaller than that in females,and the infra-acetabular corridor in males is more parallel to the sagittal plane.Therefore,the fluoroscopy angle should be adjusted for males to reduce the difficulty in screw placement when an infra-acetabular screw is placed during surgery.
关键词
髋臼/骨折/骨钉/解剖学/髋臼下方螺钉/安全通道Key words
Acetabulum/Fractures,bone/Bone nails/Anatomy/Infra-acetabular screws/Secure corridor引用本文复制引用
基金项目
国家重点研发计划(2022YFC2504304)
北京积水潭医院院级科研基金(2023OSR-GCZX 202205)
出版年
2024
NETL
NSTL
万方数据