本文選題：鎖骨　切入點(diǎn)：韌帶　出處：《中國組織工程研究》2015年42期

【摘要】：背景:經(jīng)喙鎖骨道的喙鎖韌帶重建是一種治療肩鎖關(guān)節(jié)脫位的有效方法,鎖骨鉆孔位置直接決定骨道的質(zhì)量及治療的成敗。目的:觀察鎖骨不同鉆孔位置對喙鎖韌帶重建過程中骨道位置的影響。方法:使用Mimics 13.0軟件對60個肩部的CT影像資料進(jìn)行重建得到喙鎖結(jié)構(gòu)模型。根據(jù)目前2種主流喙鎖韌帶重建方案的鉆孔位置及一種作者提出的理想的鉆孔位置在模型上虛擬手術(shù)建立骨道,并進(jìn)行相關(guān)的測量以評估其安全性。方案1:鉆孔位置距鎖骨遠(yuǎn)端30 mm,位于鎖骨表面前后緣的正中;方案2:鉆孔位置距鎖骨遠(yuǎn)端40 mm,位于鎖骨表面前后緣的正中;方案3:與錐狀結(jié)節(jié)尖端和喙突基底部的中點(diǎn)在同一直線上,在鎖骨上表面的后緣。結(jié)果與結(jié)論:重建方案1的喙突骨道在男性模型中過于偏內(nèi)側(cè)。重建方案1和2的骨道均不在鎖骨正中。重建方案3的喙突及鎖骨骨道均位于正中。以距離鎖骨遠(yuǎn)端一個固定數(shù)值來確定鉆孔位置的方法在男女性的模型中得到的骨道差異很大。鎖骨端的鉆孔位置應(yīng)與錐狀結(jié)節(jié)尖端和喙突基底部的中點(diǎn)在同一直線上,并且應(yīng)靠鎖骨上表面的后緣,才能保證喙突及鎖骨骨道的居中。
[Abstract]:Background: coracoclavicular ligament reconstruction is an effective method for the treatment of acromioclavicular joint dislocation.Aim: to observe the influence of different hole positions of clavicle on the location of coracoclavicular ligament during coracoclavicular ligament reconstruction.Methods: the coracoclavicular structure model was reconstructed from 60 shoulder CT images by Mimics 13.0 software.According to the drilling position of two kinds of mainstream coracoclavicular ligament reconstruction schemes and an ideal drilling location proposed by the author, the bone canal was established by virtual surgery on the model, and the safety was evaluated by relevant measurements.Scheme 1: the borehole position is 30 mm from the distal clavicle, which is located in the middle of the anterior and posterior edge of the clavicle surface, and the borehole position is 40 mm from the distal clavicle, which is located in the middle of the anterior and posterior edge of the clavicle surface.Scheme 3: in line with the tip of the conical nodule and the midpoint at the base of the coracoid, the posterior edge of the supraclavicular surface.Results and conclusion: the coracoid process of the reconstruction scheme 1 was too medial in the male model.Neither the osseous tract of the reconstruction schemes 1 nor 2 was in the middle of the clavicle.Both the coracoid process and the clavicle were located in the middle of reconstruction plan 3.The method of determining the location of borehole by a fixed value at the distal end of the clavicle is very different in the male and female models.The drilling position of the clavicle should be in line with the tip of the conical nodule and the middle point of the coracoid base, and the center of the coracoid process and the clavicle should be ensured by the posterior edge of the upper surface of the clavicle.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院崇明分院骨科;
【基金】：上海市高等職業(yè)教育重點(diǎn)專業(yè)建設(shè)(085工程)(FY(14)700-A5-1-17,FY(15)700-A6-1-10)~~
【分類號】：R687.3;R322

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本文編號：1719229