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| 髋臼骨折内固定的置钉安全研究 |
1 School of Mechanical Engineering, Shanghai Jiaotong University, Shanghai 200240, China
2 Department of Orthopedic Surgery, First People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200080, China
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Abstract 探讨髋臼骨折内固定危险区域安全置钉的方法，降低螺钉穿入髋关节的风险。取得173例正常成人完整骨盆CT断层扫描数据, 由此建立清晰完整的三维数字化骨盆模型，对其进行由耻骨联合到骶髂关节方向的曲线拟合，并在髋臼区域等分此曲线，获得垂直曲线的5个截面。以过进钉点并垂直于骨表面的截面曲线法向面作为参考平面，测量不同截面的进钉角度范围（α～γ）及对应的进钉深度d1、d2、d0；比较男性、女性之间存在的差异，综合手术入路的可行性，对髋臼区螺钉植入进行安全规划。结果表明，截面2的d0，截面3的β、γ 以及截面4的β，在男性和女性之间的差异具有统计学意义（P＜0.05）；安全进钉角度范围与手术入路可行范围存在部分交集。临床髋臼区域下缘置钉时要考虑到男、女性别不同所产生的差异；截面1和截面5置钉方向比较自由；截面4安全置钉角度接近可操作临界角度，临床上置钉应避开截面2和截面3。
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