髋臼前柱四边体翼型钢板-四边体挡板研发的解剖学研究

摘要

BACKGROUND: It remains poorly understood whether anterior column quadrilateral wing plate exists to solve intraoperative multiple plastic and quadrilateral in vivo shift for treating acetabular anterior column and acetabular quadrilateral body fractures.OBJECTIVE: To figure out the promising application on measurement of anatomical character parameters when designing acetabular anterior column and acetabular quadrilateral body using Mimics software. METHODS: 60 pelvic CT scan data were collected and three-dimensionally reconstructed by Mimics software. The following anatomical character parameters were measured, including the angle between plane of arcuate line of true pelvis and plane of quadrilateral surface, the four boundary lines of quadrilateral body, and the thickness of substance of bone in quadrilateral region. The projection curve on quadrilateral surface of acetabular margin and dangerous zone for screw placement were both drew. Above all, the study attempted to find out the proper safe entry point of quadrilateral screw and to measure their leaning inside angles.RESULTS AND CONCLUSION: (1) The angle between plane of arcuate line of true pelvis and plane of quadrilateral surface was not significantly different between males and females. (2) The minimum thickness of quadrilateral body in males was larger than that in females. (3) The maximum leaning angle flapper plate screw P1 and P2 for quadrilateral body was significantly smaller in males than in females, but that of screw P3 was not significantly different between males and females. (4) The application of Mimics software made it easier, more intuitive and more practical for the design or development of new plate for acetabular anterior column and acetabular quadrilateral body. The common points and difference between acetabular anterior column and acetabular quadrilateral body could be specifically described by the new anatomical character parameters, which are defined by bone surface features of pelvis.%背景:针对髋臼前柱合并四边体骨折,是否存在一种前柱四边体翼型钢板同时解决钢板术中多次塑性和四边体内移等问题呢?目的:探讨Mimics软件在髋臼前柱四边体翼型钢板-四边体挡板的设计和解剖学参数测量中的作用.方法:采用Mimics软件对共60例正常骨盆CT数据进行三维重建,测量钢板四边体挡板设计所需要的各解剖参数,包括弓状缘平面-四边体平面夹角、四边体各边界、髋臼四边体骨质厚度等.绘制髋臼在四方区骨面投影线和四边体置钉危险区,在四边体危险区以外区域寻找并设置进钉点,测量挡板螺钉的安全进钉角度.结果与结论:①弓状缘平面-四边体平面夹角男女之间比较差异无显著性意义;②男性骨质最薄厚度值显著大于女性;③男性四方区挡板螺钉P1螺钉最大内倾角和P2螺钉最大内倾角显著小于女性;P3螺钉最大内倾角男女差异无显著性意义.④结果说明,设计研发髋臼前柱四边体翼型钢板-四边体挡板可利用Mimics软件测量骨盆髋臼解剖学数据,方法简便、易行、直观;根据髋臼前柱和四边体骨面特征新定义的解剖学参数可恰当描述髋臼四边体的解剖学共同特征和差异.