髋臼下螺钉安全通道的三维数字解剖形态学研究
Three-dimensional digital anatomical morphology of secure corridor for infra-acetabular screw
吕刚 1马超 1马志强 1买买艾力·玉山 1黄异飞1
作者信息
- 1. 新疆医科大学附属中医医院骨科,乌鲁木齐 830000
- 折叠
摘要
目的 建立骨盆髋臼数字解剖学模型,比较男性与女性髋臼下螺钉安全通道的形态学参数差异.方法 回顾性分析2022年1月至2022年12月新疆医科大学附属中医医院骨科因非骨盆疾病行骨盆CT检查的正常成人骨盆数据106例,男56例、女50例,年龄(50.58±11.22)岁(范围21～68岁).利用逆向重建软件重建骨盆并导入Autodesk maya 2022软件将模型调平,利用多边形建模工具模拟置入髋臼下螺钉并测量螺钉的长度、置钉角度以及进针点与髂耻隆起顶点处的距离;通过轴向透视法测量髋臼下螺钉的直径;在Mimics21.0软件中测量进针区域面积、狭部面积及出针区域面积.比较男性与女性形态学指标的差异.结果 男性和女性髋臼下螺钉最大直径为(4.82±1.07)mm和(3.93±0.65)mm,最大长度为(97.74±93.89)mm和(88.23±4.55)mm,与矢状面夹角为-1.33°±4.96°和7.29°±6.20°,进针区域面积为(314.83± 4.79)mm2和(198.29±78.70)mm2,狭部面积为(75.61±19.00)mm2和(47.33±13.34)mm2,出针区域面积为(400.52± 88.86)mm2和(268.27±120.71)mm2,男性与女性的差异均有统计学意义(P＜0.05).男性与女性髋臼下螺钉进针点分别位于髂耻隆起顶点内侧(9.39±1.44)mm和(9.68±1.41)mm、髂耻隆起顶点前侧(8.87±1.22)mm和(9.28±1.56)mm,髋臼下螺钉与骨盆前平面夹角分别为52.69°±7.38°和52.32°±1.24°,差异均无统计学意义(P＞0.05).当螺钉直径为3.5 mm时,分别有88％(49/56)的男性和76％(38/50)的女性骨盆中存在可供螺钉通过的骨通道,差异无统计学意义(x2=2.375,P=0.123);但当螺钉直径为4.5 mm时,分别有59％(33/56)的男性和20％(10/50)的女性骨盆中存在可供螺钉通过的骨通道,差异有统计学意义(x2=16.603,P＜0.001).结论 髋臼下骨通道参数的个体差异较大,男性髋臼下螺钉的长度、直径、进针区域面积、狭部面积及出针区域面积均大于女性,与矢状面的夹角小于女性;男性与女性髋臼下螺钉的进针点与髂耻隆起的距离以及螺钉与骨盆前平面夹角无明显差异;男性髋臼下骨通道中直径3.5 mm螺钉通过率与女性无明显差异,直径4.5 mm螺钉通过率高于女性.
Abstract
Objective To establish a digital anatomical model of the pelvic and compare the differences in morphologi-cal parameters of the infra-acetabular screw safety channel between men and women.Methods A retrospective analysis was per-formed on the pelvic data of 106 normal adults who underwent plain pelvic CT scan for non-pelvic disorders diseases in the Affili-ated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from January 2022 to December 2022,including 56 males and 50 females,aged 50.58±1 1.22 years(range,21-68 years).Use reverse reconstruction software to reconstruct the pelvis and import it into Autodesk maya 2022 software to level the model.Use polygonal modeling tools to simulate the insertion of infra-acetabular screws and measure the length of the screw,the screw insertion angle,and the distance between the needle entry point and the apex of the iliopubic eminence.Measure the diameter of the infra-acetabular screw through axial fluoroscopy;measure the needle entry area,narrow area and needle exit area in Mimics 21.0 software;compare the differences in the above indicators be-tween men and women.Results The maximum diameters of male and female infra-acetabular screws were 4.82±1.07 mm and 3.93±0.65 mm respectively;the maximum lengths were 97.74±93.8 mm and 88.23±4.55 mm respectively;the angles with the sagit-tal plane were-1.33°±4.96°and 7.29°±6.20° respectively;the needle insertion areas were 314.83±4.79 mm2 and 198.29±78.70 mm2 respectively,the narrow areas were 75.61±19.00 mm2 and 47.33±13.34 mm2 respectively,and the needle exit areas were 400.52±88.86 mm2 and 268.27±120.71 mm2 respectively;the differences between male and female were statistically significant(P＜0.05).The infra-acetabular screw insertion points for men and women are respectively 9.39±1.44 mm and 9.68±1.41 mm in-side the iliopubic eminence apex,and 8.87±1.22 mm and 9.28±1.56 anterior to the iliopubic eminence apex;the angles between the infra-acetabular screw and the anterior pelvic plane were 52.69°±7.38°and 52.32°±1.24°respectively;the differences were not statistically significant(P＞0.05).When the screw diameter was 3.5 mm,88％(49/56)of men and 76％(38/50)of women have corri-dor in the pelvis for screws to pass through,and the difference was not statistically significant(x2=2.375,P=0.123).But when the screw diameter was 4.5 mm,59％(33/56)of men and 20％(10/50)of women have corridor in the pelvis for screws to pass through,and the difference was statistically significant(x2=16.603,P＜0.001).Conclusion There are large individual differences in infra-acetabular corridor parameters.The length,diameter,needle entry area,narrow area and needle exit area of the infra-acetabular screw in men are larger than those in women,while the angle with the sagittal plane in men is smaller than that in women.There is no significant difference between men and women in the distance between the insertion point of the infra-acetabular screw and the iliopubic eminence and the angle between the screw and the anterior pelvic plane.There was no significant difference in the pass rate of screws with a diameter of 3.5 mm between males and females in the acetabular canal,while the pass rate of screws with a di-ameter of 4.5 mm was higher than that of females.
关键词
髋臼/骨折/模型,解剖学/安全通道/骨螺丝Key words
Acetabulum/Fractures,bone/Models,anatomic/Secure corridor/Bone screws引用本文复制引用
基金项目
新疆维吾尔自治区科技支疆项目计划(指令性)(2020E02126)
出版年
2024
NETL
NSTL
万方数据