Three-dimensional digital anatomical morphology of secure corridor for infra-acetabular screw
10.3760/cma.j.cn121113-20231207-00367
- VernacularTitle:髋臼下螺钉安全通道的三维数字解剖形态学研究
- Author:
Gang LYU
1
;
Chao MA
;
Zhiqiang MA
;
Yushan MAIMAIAILI
;
Yifei HUANG
Author Information
1. 新疆医科大学附属中医医院骨科，乌鲁木齐 830000
- Keywords:
Acetabulum;
Fractures, bone;
Models, anatomic;
Secure corridor;
Bone screws
- From:
Chinese Journal of Orthopaedics
2024;44(7):430-437
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a digital anatomical model of the pelvic and compare the differences in morphological parameters of the infra-acetabular screw safety channel between men and women.Methods:A retrospective analysis was performed on the pelvic data of 106 normal adults who underwent plain pelvic CT scan for non-pelvic disorders diseases in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from January 2022 to December 2022, including 56 males and 50 females, aged 50.58±11.22 years (range, 21-68 years). Use reverse reconstruction software to reconstruct the pelvis and import it into Autodesk maya 2022 software to level the model. Use polygonal modeling tools to simulate the insertion of infra-acetabular screws and measure the length of the screw, the screw insertion angle, and the distance between the needle entry point and the apex of the iliopubic eminence. Measure the diameter of the infra-acetabular screw through axial fluoroscopy; measure the needle entry area, narrow area and needle exit area in Mimics 21.0 software; compare the differences in the above indicators between men and women.Results:The maximum diameters of male and female infra-acetabular screws were 4.82±1.07 mm and 3.93±0.65 mm respectively; the maximum lengths were 97.74±93.8 mm and 88.23±4.55 mm respectively; the angles with the sagittal plane were -1.33°±4.96°and 7.29°±6.20° respectively; the needle insertion areas were 314.83±4.79 mm 2 and 198.29±78.70 mm 2 respectively, the narrow areas were 75.61±19.00 mm 2 and 47.33±13.34 mm 2 respectively, and the needle exit areas were 400.52±88.86 mm 2 and 268.27±120.71 mm 2 respectively; the differences between male and female were statistically significant ( P<0.05). The infra-acetabular screw insertion points for men and women are respectively 9.39±1.44 mm and 9.68±1.41 mm inside the iliopubic eminence apex, and 8.87±1.22 mm and 9.28±1.56 anterior to the iliopubic eminence apex; the angles between the infra-acetabular screw and the anterior pelvic plane were 52.69°±7.38°and 52.32°±1.24°respectively; the differences were not statistically significant ( P>0.05). When the screw diameter was 3.5 mm, 88% (49/56) of men and 76% (38/50) of women have corridor in the pelvis for screws to pass through, and the difference was not statistically significant (χ 2=2.375, P=0.123). But when the screw diameter was 4.5 mm, 59% (33/56) of men and 20% (10/50) of women have corridor in the pelvis for screws to pass through, and the difference was statistically significant (χ 2=16.603, P<0.001). Conclusion:There are large individual differences in infra-acetabular corridor parameters. The length, diameter, needle entry area, narrow area and needle exit area of the infra-acetabular screw in men are larger than those in women, while the angle with the sagittal plane in men is smaller than that in women. There is no significant difference between men and women in the distance between the insertion point of the infra-acetabular screw and the iliopubic eminence and the angle between the screw and the anterior pelvic plane. There was no significant difference in the pass rate of screws with a diameter of 3.5 mm between males and females in the acetabular canal, while the pass rate of screws with a diameter of 4.5 mm was higher than that of females.
