| 摘要: |
| 目的 了解骨盆环各部分骨质厚度及其外周大血管和神经的占位,为骨盆骨折螺钉固定提供依据。方法 选择正常的骨盆骨性标本74例(男40例,女性34例）,以盆腔中心为圆点,按照顺时针方向沿骨盆界线测量各部分骨的厚度；选取30例正常骨盆部CT片,以同样方法 测量骨盆环各点骨的厚度。解剖尸体标本,按照顺时针方向解剖观察骨盆环外周的大血管和神经的位置及走行。结果 (1)骨盆环沿骨盆界线在0:00(12:00)到6:00整点的骨质厚度(mm）的骨质标本测量结果 分别为25.36±3.03(女24.48±2.16）、 32.59±7.21(女22.88±2.13)、24.06±2.89(女20.40±2.07)、44.12±3.97 (女37.55±3.60)、27.88±2.36(女22.68±2.26)、13.80±2.14(女10.22±2.05)、15.04±2.31(女13.53±2.22),CT测量结果 分别为25.44±2.95、30.45±7.14、24.49±2.74、44.35±4.21、27.66±2.12、14.06±1.86、15.85±2.15。(2)按顺时针刻度确定骨盆环周围重要血管神经的位置为:股神经、股动静脉的位置在4:00～4:30点之间(左)和7:00～7:30点之间(右)；闭孔神经血管位置在4:30～5:00之间(左)和7:00～7:30之间(右)。结论 以盆腔中心为圆点,用顺时针刻度确定骨盆各点的位置及其周围的大血管和神经位置的方法 较为简便。掌握骨盆环各部的骨质厚度,对骨盆骨折螺钉内固定有重要指导作用。 |
| 关键词: 骨盆骨折 螺钉固定 骨质厚度 应用解剖 |
| DOI：10.3724/SP.J.1008.2012.001116 |
| 投稿时间：2012-07-20修订日期：2012-09-27 |
| 基金项目: |
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| Screw fixation of pelvic fractures: the applied anatomy and clinical significance |
| ZHANG Gui-yuan1*,WANG Kai-ming1,WANG He-bin2 |
(1. Qiannan Medical College for Nationalities, Duyun 558000, Guizhou, China
2. Department of Imaging, Affiliated Hospital of Qiannan Medical College for Nationalities, Duyun 558000, Guizhou, China
*Corresponding author.) |
| Abstract: |
| ObjectiveTo understand the thickness of each section of the pelvic loop and the positions of the peripheral large vessels and nerves, so as to provide evidence for the screw fixation of pelvic fractures. MethodsA total of 74 normal osseous specimens of the pelvis (male 40 cases, female 34 cases) were selected for the present study. Pelvic center was taken as the dot, and the thickness of the pelvic bone along the pelvis line were measured in the clockwise direction. Thirty 30 CT images of normal pelvis were used to measure the bone thickness of the pelvic loop in the same manner. Moreover, cadaver specimens were also dissected and the position line of the peripheral large vessels and nerves of the pelvic loop were observed in the clockwise direction. Results(1) The thicknesses (mm) of the pelvic bone along the pelvis line（from 0:00 \[12:00\] to 6:00) were 25.36±3.03 (female 24.48±2.16), 32.59±7.21 (female 22.88±2.13), 24.06±2.89 (female 20.40±2.07), 44.12±3.97(female 37.55±3.60), 27.88±2.36 (female 22.68±2.26), 13.80±2.14 (female 10.22±2.05), and 15.04±2.31 (female 13.53±2.22), respectively; and the results of CT measurement were 25.44±2.95, 30.45±7.14, 24.49±2.74, 44.35±4.21, 27.66±2.12, 14.06±1.86 and 15.85±2.15, respectively. (2)Based on the clockwise scale, the positions of the main vessels and nerves around the pelvic loop were as follows: the positions of the femoral nerves and the femoral arteries and veins were between 4:00 and 4:30 on the left and between 7:00 and 7:30 on the right; the positions of obturator nerve vessels were between 4:30 and 5:00 on the left and between 7:00 and 7:30 on the right. ConclusionWhen pelvic center is taken as the dot, it is simple and practical to determine the position of each point of the pelvis and the large vessels and nerves in the clockwise direction. The thickness of each part of the pelvic loop is important to guide screw internal fixation of the pelvic fracture. |
| Key words: pelvic fracture screw fixation bone thickness applied anatomy |
