不稳定骨盆损伤中骶髂关节脱位的临床解剖研究.doc

不稳定骨盆损伤中骶髂关节脱位的临床解剖研究 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：不稳定骨盆损伤中骶髂关节脱位的临床解剖研究 1 1 材料与方法 2 2 结果 4 3 讨论 5 文2：不稳定骨盆骨折合并骶髂关节脱位的治疗方法选 7 1 资料与方法 7 2 结果 9 4 参考文献 11 参考文摘引言： 12 原创性声明（模板） 13 文章致谢（模板） 14 正文 不稳定骨盆损伤中骶髂关节脱位的临床解剖研究 文1：不稳定骨盆损伤中骶髂关节脱位的临床解剖研究 The Study of Displacement Changes of the Sacroiliac Joint in Utable Pelvic Injury Abstract： Objective To determine the average articular contact area between the sacrum and ilium at the sacroiliac joint using computer analysis. Methods Thirty normal adult drybone sacrum and ilium specime(left sides of pelvis) were used. Simulating all utable pelvic injury， the sacroiliac joint was displaced in three directio by moving the ilium posteriorly， superiorly， and posterosuperioriorly. After each displacement， using software computer analysis system to calculated the contact area between the sacrum and ilium at the sacroiliac joint. Results The data showed that the average articular surface area of the male sacroiliac joint( mm2) was approximately ％ greater than the average surface area of the female sacroiliac joint( mm2)(P＜). The average articular contact area between the sacrum and ilium at the sacroiliac joint was lowest with the ilium displaced posterosuperiorly compared to equal displacements superiorly or posteriorly(P＜). Conclusion This study quantitatively illustrated the loss of contact surface area between the sacrum and ilium during various displacements of the ilium， thus indicating the clinical crosssection area available for open reduction and internal fixation or fusion. Key words： sacroiliac joint； injury； displacement 不稳定骨盆骨折包括旋转及垂直不稳，半骨盆通常向后、上或后上方移位。移位的骶髂关节可能导致骨折不愈合、畸形愈合、两侧下肢不等长、骨盆关节痛、下腰痛或创伤后骶髂关节炎等并发症［1～3］。为了更好地理解骶髂关节损伤后移位的情况，使用计算机软件分析骶髂关节移位后残留关节面接触面积的改变。临床医生只有更好地理解这种病理变化，才能提供更好的 治疗 方案。 1 材料与方法 实验材料 选用30具除去韧带结构的正常成人干燥左侧半骨盆标本，共30个骶髂关节，男女各15具；年龄20～57 岁。排除标本畸形、肿瘤、外伤及解剖变异等情况。采用Philips briliance 6排螺旋CT机扫描标本的骶髂关节部分。扫描条件为：球管电压120 kV，电流140mA，单层扫描时间 s，螺距，平扫层厚2 mm。无间隔连续扫描，保证扫描的连续性和精确