發(fā)布時(shí)間：2018-06-08 16:12

  本文選題：髖臼 + 重建鋼板　； 參考：《吉林大學(xué)》2006年碩士論文

【摘要】：目的:主要是通過(guò)對(duì)髖臼后柱的一些解剖結(jié)構(gòu)進(jìn)行觀察和測(cè)量,根據(jù)髖臼在后柱上的投影劃分螺釘固定的危險(xiǎn)區(qū)和相對(duì)安全區(qū),將這些危險(xiǎn)區(qū)域提示給臨床醫(yī)生,使其對(duì)髖臼后柱的解剖結(jié)構(gòu)有個(gè)整體的理解,避免螺釘置入關(guān)節(jié)和減少術(shù)中因?yàn)槁葆斶M(jìn)入關(guān)節(jié)而導(dǎo)致的一系列副損傷。 實(shí)驗(yàn)方法:由同一專業(yè)人員在X線下對(duì)髖骨標(biāo)本進(jìn)行一些指標(biāo)的測(cè)量,包括:髖臼緣到髖臼投影底的垂直距離、髖臼上、下緣位置、髖臼投影底到骨盆內(nèi)緣垂直距離、過(guò)髖臼底切線與髖臼上緣切線的交點(diǎn)45°角到髖臼外緣的距離、過(guò)髖臼底切線與髖臼下緣切線的交點(diǎn)45°角到髖臼外緣的距離。 實(shí)驗(yàn)結(jié)果:髖臼上緣在坐骨大切跡頂點(diǎn)下0.56±0.28cm,髖臼下緣在坐骨棘中點(diǎn)的下方0.83±0.34cm,髖臼緣到髖臼投影底的垂直距離1.18±0.17cm,髖臼底切線與髖臼上緣切線的交點(diǎn)45°角到髖臼外緣距離0.99±0.09cm,髖臼底切線與髖臼下緣切線的交點(diǎn)45°角到髖臼外緣的距離 0.86±0.20cm,髖臼投影底到骨盆內(nèi)緣垂直距離1.91±0.18cm。結(jié)論:1.通過(guò)對(duì)髖臼后柱的解剖結(jié)構(gòu)的觀測(cè),能利用坐骨大切跡頂點(diǎn)、坐骨棘中點(diǎn)和坐骨大孔緣將髖臼在后柱的投影分為幾部分,包括:髖臼區(qū)、危險(xiǎn)區(qū)(螺釘固定置入的危險(xiǎn)區(qū))和相對(duì)安全區(qū)。2.可以根據(jù)5個(gè)點(diǎn)描繪出髖臼在后柱上的的半環(huán)形投影區(qū)即為危險(xiǎn)區(qū):髖臼底切線與髖臼上緣切線的交點(diǎn)45°角到髖臼外緣距離0.99±0.09cm,髖臼底切線與髖臼下緣切線的交點(diǎn)45°角到髖臼外緣的距離0.86±0.20cm,髖臼投影底到骨盆內(nèi)緣垂直距離1.91±0.18cm,髖臼上緣在坐骨大切跡頂點(diǎn)下0.56±0.28cm,髖臼下緣在坐骨棘中點(diǎn)的下方0.83±0.34cm。在這半環(huán)形區(qū)域以外的我稱之為相對(duì)安全區(qū)。隨后對(duì)髖臼后柱進(jìn)行模擬的螺釘固定,在髖臼危險(xiǎn)區(qū)內(nèi)以30°～40°的角度進(jìn)釘、在相對(duì)安全區(qū)內(nèi)以小于100°任意角度進(jìn)釘,內(nèi)固定物安全準(zhǔn)確性為100㳠。3.在對(duì)髖臼后柱骨折切開(kāi)復(fù)位內(nèi)固定的手術(shù)中,只要顯露出或者觸及坐骨大切跡頂點(diǎn)和坐骨棘,不用打開(kāi)關(guān)節(jié)腔,根據(jù) 實(shí)驗(yàn)數(shù)據(jù)就可以描繪出危險(xiǎn)區(qū),不需要更多的組織顯露,盡可能的減少手術(shù)的副損傷。
[Abstract]:Objective: to observe and measure some anatomical structures of the posterior column of the acetabular, divide the dangerous area of screw fixation and the relative safety zone according to the projection of the acetabular on the posterior column, and present these dangerous areas to the clinician. To give it an overall understanding of the anatomical structure of the posterior column of the acetabulum, Avoid screw placement and reduce a series of collateral injuries caused by screws entering the joint during the operation. Including the vertical distance from the acetabular margin to the acetabular projection floor, the position of the acetabular upper and lower edge, the vertical distance from the acetabular projection base to the pelvic inner margin, and the distance between the intersection of the acetabular bottom tangent and the acetabular superior edge tangent to the outer acetabular edge. The distance between the intersection point of the acetabular bottom tangent and the acetabular bottom tangent to the outer edge of the acetabulum. Results: the acetabular upper edge is 0.56 鹵0.28 cm below the apex of the great notch of the ischium, the inferior edge of the acetabular is 0.83 鹵0.34 cm below the midpoint of the sciatic spine, and the acetabular edge is below the projected base of the acetabular. The vertical distance was 1.18 鹵0.17 cm, the distance between the intersection point of acetabular bottom tangent and the superior acetabular edge was 0.99 鹵0.09 cm, the distance between 45 擄angle of acetabular bottom tangent and acetabular edge was 0.86 鹵0.20 cm, and the vertical distance between acetabular bottom and inner edge of pelvis was 1.91 鹵0.18 cm. Conclusion 1. By observing the anatomical structure of the posterior column of the acetabulum, the projection of the acetabulum in the posterior column can be divided into several parts, including the acetabular region, the midpoint of the sciatic spine and the margin of the ischial foramen. Danger area (danger area fixed by screw) and relative safety zone. 2. The semi-circular projection region of acetabular on the posterior column can be described as the dangerous area according to five points: the intersection point between acetabular bottom tangent and acetabular upper edge is 45 擄angle to acetabular outer edge 0.99 鹵0.09 cm, and the intersection point between acetabular bottom tangent line and acetabular lower edge tangent line is 0.99 鹵0.09 cm. The distance from 45 擄angle to the outer edge of the acetabular is 0.86 鹵0.20 cm, the vertical distance from the bottom of the acetabular projection to the inner edge of the pelvis is 1.91 鹵0.18 cm, the upper edge of the acetabulum is 0.56 鹵0.28 cm below the apex of the great notch of the ischium, and the inferior edge of the acetabulum is 0.83 鹵0.34 cm below the middle point of the sciatic spine. Outside this semi-circular area I call it a relative security zone. The posterior post of the acetabulum was then imitated with screw fixation. The internal fixation was made at an angle of 30 擄or 40 擄in the acetabular dangerous area and at any angle less than 100 擄in the relative safety zone. The safety and accuracy of the internal fixator was 100 擄路3. In the operation of open reduction and internal fixation of acetabular posterior column fracture, as long as the apex of the great notch of the ischium and the sciatic spine are exposed or touched, and the articular cavity is not opened, the dangerous area can be delineated according to the experimental data, and no more tissue exposure is needed. Minimize surgical collateral damage.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R322;R687.3

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本文編號(hào)：1996396