逆行髋臼前柱拉力螺钉内固定应用解剖学探究.docVIP

逆行髋臼前柱拉力螺钉内固定应用解剖学探究 　作者：王庆贤 张英泽 潘进社 彭阿钦 吴希瑞 王鹏程 李衡 张世强 李亚洲 刘向东 赵立力 【关键词】 髋臼 摘要：［目的］为逆行髋臼前柱拉力螺钉内固定提供应用解剖学基础。［方法］取半骨盆标本20个，自髋臼切迹至髋臼上缘每隔50 mm作系列截骨面，找到最小截骨面，用圆盘法确定其圆心及直径，用斯氏针由该截面的圆心逆行打入，在髂骨后外侧穿出。将该截面下方的系列截面解剖复位，再将斯氏针顺行打入前柱，由耻骨上支前外侧穿出，该穿出点为P，P即为逆行髋臼前柱拉力螺钉入钉点。测量其在髋臼前柱骨皮质内的长度，将耻骨结节命名为A，将髂耻隆起命名为B，测量AB及PA的距离，并观察该斯氏针的方向。［结果］最小截骨面位于髋臼切迹上方150 mm处，该截面平均直径为(49±17)mm，髋臼前柱骨皮质内斯氏针长度为(868±72)mm，P位于耻骨上支前缘闭孔嵴上，P距耻骨结节(A)的距离PA为(23±04)mm，耻骨结节(A)距髂耻隆起(B)的距离AB为(47±03)mm，P约为AB的中点，该斯氏针与弓状线平行。［结论］逆行髋臼前柱拉力螺钉入钉点P位于耻骨上支耻骨结节与髂耻隆起中点处的闭孔嵴上，P距耻骨结节(23±04)mm，该螺钉最大直径为(49±17)mm，最大长度为(868±72)mm，该螺钉与弓状线平行。 　　关键词：髋臼；前柱；逆行拉力螺钉；内固定；应用解剖学 　　Anatomical study of retrograde lag screw fixation in acetabular anterior column 　　Abstract：［Objective］To provide applied anatomical basis for the placement of retrograde lag screw in the acetabular anterior column［Method］Twenty hemipelves were harvested for this studyAll specimens were sectioned at 50 mm intervals perpendicular to the anterior surface of the anterior columnSuccessive crosssections were made from the inferior bony acetabular margin to the superior bony margin of the acetabulumThe center point and the diameter of the smallest crosssection were determined by disc methodA Steinmann pin was put retrogradely through the center point of the smallest crosssectionThen the crosssections below were repositioned anatomically,the Steinmann pin was forced downward with the help of a drillThe length of the Steinmann pin in the anterior column was measuredThe exit in the superior ramus of pubis,the pubic tubercle,and the iliopubic eminence was named P,A and B respectivelyThe distance between PA and AB were measuredThe inclination of the Steinmann pin was observed［Result］The smallest crosssection was 150 mm superior to the inferior bony acetabular marginThe diameter of this section averaged (49±17)mmThe mean length of the Steinmanm pin in the anterior column was (868±72)mmP was just on the obturator crestPA was (23 ±04)mm,AB was (47±03)mmP was about the midpoint of ABTh