The Nail Screw Pelvic Method Of Clinical Anatomy Studies

[Objectives] To China adult after coming through the coming on to before the anchor channel under high measurement and analysis of imaging, determine the qia the use of ilium after implantation screw nails way Angle parameters, this paper discusses the feasibility of the ilium screw placement and security, to strengthen the sacroiliac joint adjacent to the understanding of the anatomical structure, developed for the americans to provide the reference data of ilium nail.[Methods] the anticorrosion pelvic specimens with18, pelvic area of soft tissue carefully done. Measurement data are:(1) the S1pedicle observation and measurement:(1) the S1pedicle high;(2) SI pedicle wide;(3) to observe the lateral aspect of the ilium after wing after the shape of the hip line and occurrence rate;(4) the s1needle into the point to pedicle center distance;(5) needle into the s1points to s1cortex of vertebral body before side distance:(6) needle into the point and siatic big cut trace and after the relationship between the qia;(7) the sacroiliac screws into the needle with the direction of the ilium after wing the lateral aspect of the relationship.(2) the S2pedicle measurement results:(1) S2pedicle wide;(2) the s2pedicle high;(3) the diameter nails;(4) needle into the S2points to pedicle center distance;(5) points to the needle thorn and siatic after coming under cut trace relationship;(6) points to needle into the S2vertebral center distance;(7) ilium after wing drills and the lateral aspect of the Angle.(3) using sacral nailing for pelvic ring after injury patients18patients, the establishment of the nail into the research method, the follow-up tracking its therapeutic effect. [Results](1) the S1pedicle measurement results:(1) the experiment after hip line extending down a straight line can be used as S1needle into the point positioning symbol in54of ilium appeared in the wing26side;(2) the S1pedicle high20.2+/-23mm;(3) S1pedicle wide and27.7+/-2.0mm:(4) S1point to needle into the pedicle center distance49.1+/-3.6mm;(5) the needle1point to s1cortex of vertebral body before side range86.5+/-3.8mm;6the needle point is located in s1under24.6ahead after iliac mark+/-2.9mm, sciatic big cut above mark41.8+/-3.4mm;7direction perpendicular to the needle for the lateral aspect of the ilium after wing, then end to tilt7.1+1-23°, back to tilt7.7+/-3.8°.(2) the S2pedicle measurement results:(1) S2pedicle wide and14.8+/-1.9mm;(2) the s2pedicle high17.6+/-1.9mm;(3) the diameter was11.5+/-1.4mm:(4) needle into the s2points to pedicle center distance53.1+/-5.1mm;(5) points to needle into the S2vertebral center distance64.7+/-4.9mm;(6) in vertical direction needle into the middle of the sagittal and the lateral aspect of the ilium after wing with an Angle of62.3+/-2.7°(level).(7) the needle in qia s2point after mark28.7ahead+/-4.1mm, sciatic big cut above mark15.3+/-3.1mm;(3) clinical application evaluation:18cases of sacral was placed specimen19pieces, review the X-ray films see sacral nail position normal, pelvic reset is good, which both are located in s1pedicle and vertebral body, for more than half a year after patients with follow-up, Majeed curative effect according to the evaluation standard, to stand, sit, pain, the sex life and work in his recovery evaluation, the excellent-good is seventeen cases, pelvic did not appear shift, did not appear to take off the screw, screw breakage. Two cases of the saddle area left feeling decline, did not appear, the blood vessel damage nerve complications.[Conclusion](1) the s1pedicle sacroiliac joint screws should choose long for75mm screws for appropriate:(2) the s1pedicle level sacroiliac joint screws into the needle is located in the point of sciatic cut trace40mm above, after coming under the front was25mm;(3) the direction perpendicular to the needle for the lateral aspect of the ilium after wing, then end to tilt (5～10)°, back to tilt (5～10)°;(4) the s2pedicle screws level sacroiliac joints of needle points out in15mm above sciatic cut trace, after coming under30mm ahead spines;(5) the S2pedicle sacroiliac joint screws should choose smaller diameter short screws;6in the middle of the perpendicular to the direction the needle sagittal and the lateral aspect of the wing and the high an Angle of60°(plane);7S2pedicle nail is smaller than the diameter s1pedicle.