【摘要】：一、研究背景 近年來骨盆創(chuàng)傷的治療獲得了長足的進(jìn)步,切開復(fù)位內(nèi)固定(Open Reduction and Internal Fixation,ORIF)成為骨盆骨折和髖臼骨折的一種重要治療手段,在骨盆內(nèi)固定過程中有時會發(fā)生螺釘穿入關(guān)節(jié)內(nèi)、損傷盆腔內(nèi)重要血管或神經(jīng)等嚴(yán)重并發(fā)癥,因此了解骨盆各個部位的厚度、重要血管和神經(jīng)距骨壁的距離以及它們在骨盆表面的投影是防止發(fā)生血管和神經(jīng)意外損傷的基礎(chǔ)和關(guān)鍵。 雖然國外一些學(xué)者相繼報道了后柱拉力螺釘技術(shù),但這些學(xué)者使用的技術(shù)中的螺釘?shù)倪M(jìn)釘點(diǎn)、方向和長度均不相同,缺乏統(tǒng)一性,螺釘穿入關(guān)節(jié)內(nèi)或損傷重要的血管和神經(jīng)的危險較大,因此通過定量解剖學(xué)研究,尋找螺釘?shù)淖罴堰M(jìn)釘點(diǎn)、方向和長度是減少上述并發(fā)癥的關(guān)鍵。目前有關(guān)后柱拉力螺釘技術(shù)的定量解剖學(xué)文獻(xiàn)極少,而且他們確定螺釘進(jìn)釘點(diǎn)的方法過于繁瑣,臨床使用不方便。 目前關(guān)于整個骨盆厚度的研究未見文獻(xiàn)報道,我們在骨盆的內(nèi)側(cè)面和外側(cè)面分別建立一個坐標(biāo)系,測量出坐標(biāo)系中各點(diǎn)的厚度,畫出等厚線,在不同的等厚線之間分別用不同的顏色填充,形成幾個不同的厚度區(qū)域。除髂外血管、閉孔血管神經(jīng)束、骶髂關(guān)節(jié)、骶骨側(cè)塊或骶2椎弓根外,骨盆內(nèi)其他的重要結(jié)構(gòu)在髂骨外板的體表投影未見文獻(xiàn)報道。
[Abstract]:Background: in recent years, great progress has been made in the treatment of pelvic trauma. Open reduction and internal fixation (Open Reduction and Internal Fixation,ORIF) has become an important treatment for pelvic fractures and acetabular fractures. In the course of pelvic internal fixation, serious complications such as screw penetration into the joint and injury of important blood vessels or nerves in the pelvic cavity occur, so the thickness of each part of the pelvis is understood. The distance between the important blood vessels and the talus wall and their projection on the pelvic surface are the basis and key to prevent the accidental injury of blood vessels and nerves. Although some foreign scholars have reported on the technique of rear column pull screw, the point, direction and length of screw in the technique used by these scholars are different and lack of uniformity. The risk of screws penetrating into joints or damaging important blood vessels and nerves is greater, so finding the best point of screw entry through quantitative anatomical study, direction and length is the key to reduce the complications mentioned above. At present, there are few quantitative anatomical literatures on the technique of posterior column pull screw, and their method of determining the point of screw entry is too cumbersome and inconvenient for clinical use. At present, there is no literature report on the whole pelvis thickness. We set up a coordinate system on the inner and outer sides of the pelvis, measure the thickness of each point in the coordinate system, draw the equal thickness line. Different thickness lines are filled with different colors to form several different thickness regions. Except for the external iliac vessels, obturator vascular nerve bundles, sacroiliac joints, sacrum lateral mass or sacral pedicle, other important structures in the pelvis have not been reported in the body surface projection of the iliac external plate.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2005
【分類號】：R687.3;R322

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