Objective To discuss the applied anatomical basis of pereutaneous retrograde screw fix-ation for the anterior Column fractures of acetabular. Methods The CT scans images of 164 (80 males and 84 females without any bony problem, with the mean age of 49.1 years) hemipelves were obtained and the virtual three-dimensional reconstruction models were created. Virtual cylindrical implants were placed in-traosseously in the anterior column of acetabular. The maximum diameter, length and the insert direction were determined for lag screws and were calculated. The perpendicular distances from the insert point (A) of virtual cylindrical implants to the rim of superior ramus (B) and pubic symphyses (C) were measured. In the same model, cross-sections of the anterior columns were created and the diameters of them were measured. A disc was placed in the minimum cross-section, and its maximum diameter was measured. Results The mean maximum diameter and length of virtual cylindrical implants were (8.16±1.21) mm and (109.39±8.95) mm. And the angle to the transverse plane, coronal plane and sagittal plane were 39.66°±3.92°、20.81°±4.58°and 42.66°±3.23°respectively. The distant of AB and AC were (18.42±4.82) mm and (17.76±2.63) mm. The dif-ferences of the diameter, length, and distance of AB between the male and female were of statistical signifi-cance. The mean smallest cross-sectional diameter and the mean maximal discs diameter were both larger than the mean maximum diameter of the equivalent virtual cylindrical implants. Conclusion The anterior column of male would accommodate with the screws of 6.5 mm, but not to all of female. The insert points of screws are difference between male and female. The size of the screws used for anterior column should not be based solely on the measurement of cross-sectional diameter.%目的 探讨髋臼前柱骨折经皮逆行拉力螺钉固定的应用解剖学基础.方法 收集82例164个成人半骨盆CT扫描数据,重建骨盆三维模型.男80个,女84个年龄18～80岁,平均(49.1±18.4)岁.在髋臼前柱置入虚拟三维圆柱体,模拟逆行拉力螺钉固定,计算其最大直径、长度、方向以及置入点(A)到耻骨联合(B)和耻骨上支上缘(C)的垂直距离.在相同的三维重建模型上,垂直髋臼前柱前侧面进行模拟截骨,测量截骨面的直径.找出最小的截骨面,用圆盘法测量其直径.结果 虚拟三维圆柱体的平均最大直径为(8.16±1.21)mm,最大长度为(109.39±8.95)mm,与水平面、冠状面和矢状面的夹角分别为39.66°±3.92°、20.81°±4.58°和42.66°±3.23°,AB和AC的长度分别为(18.42±4.82)mm和(17.76±2.63)mm.虚拟三维圆柱体的最大直径、长度以及AB的长度在男、女之间的差异有统计学意义.截骨面的平均最小直径和最小截骨面的圆盘直径均明显大于虚拟三维圆柱体的平均最大直径.结论 所有男性髋臼前柱可容纳6.5 mm的螺钉,但部分女性无法使用6.5 mm的螺钉,且男、女的进针点不同.螺钉的直径不能仅靠截骨面的直径确定.
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