| Objective: To detective the applied anatomical study basis of the acetabulum anterior column screw tunnel.Methods: Collected 30 healthy adults MSCT scans images data,included 15 male and 15 female volunteers.Age:25~61years,Height:1.6~1.83 m,Weight:51~86Kg.Transmitted CT scans data to Mimics for reconstruction virtual three-dimensional hemipelves models.Used Virtual Cylindrical Bolts replaced screws to simulated anterior column acetabulum fractures screw fixation.Calculated the VCBs maximum diameter,length and insert direction.Calculated the angle between the VCBs and the pelvic midline in the anteroposterior and inlet view.Simulated the anterior column anterograde screws fixation,Calculated the distances between the VCBs insert point(A)to the ipsilateral anterior superior spine(S),anterior inferior spine(I),acetabulum dome vertex(C)and the top of the greater sciatic notch(N),respectively.Simulated the anterior column retrograde scres fixation,Measured the distances between the VCBs insert point(B)to the pubic symphysis midpoint(M)and pubic tubercle(D),respectively.In the same models used incise function to separated the anterior column of the acetabulum.The virtual incise was started in the screw insert point and ended in the screws exit point,another incises parallel to the anterior column axis.Cross-sections of 1cm of the anterior column were created on the 3D hemipelves models and the concentric circles diameters were calculated.Recorded the minimum Cross-sections concentric circles diameter and position.Results: The men’s maximun diameter and length of screw was(7.0±0.47)mm and(111.9±3.7)mm;the female was(5.6±0.66)mm and(103.4±3.6)mm,the difference of the diameter and length between the male and female were of statistical significance.the men’s angle to the transverse plane,coronal plane and sagittal plane were(39.94°±2.28°)、(20.43°±2.07°)、(42.17°±2.42°),the female angle were(39.76°~2.78°)、(20.55°±1.94°)、(40.42°±2.88°).The difference of the sagittal plane insert direction was statistical significance between the male and female.The men’s distances of AS,AI,AN,AC were(65.91±5.98)mm、(58.95±5.01)mm、(35.62±8.7)mm、(32.88±4.39)mm,the female’s distances were(62.98±5.37)mm、(50.54±4.7)mm、(31.53±3.92)mm、(27.81±2.35)mm.There were statistical difference between the male and female in the AS,AI,AC,AN.The men’s distances of BM,BD were(23.42±3.1)mm、(15.36±3.42)mm,the female distances were(26.60±3.53)mm、(12.42±2.78)mm.The difference of the BM,BD between the male and female were of statistical significance.The angle between the screw and the pelvic midline in the anteroposterior(∠VMP)and inlet view(∠VMP’)were(53.96°±2.56°),(45.65°±1.95°),the female angle were(54.22°±3.27°)、(54.49°±3.7°).The inlet view angle(∠VMP’)had statistical difference.The man and female’s minimum Cross-sections concentric circles diameters were larger than the mean screw maximum diameter.Conclusion:(1).High precision virtual three-dimensional pelvic models could be reconstructed by the Mimics based on MSCT scans images data and DICOM technology.(2).The anterior column of male could accommodate with the screws of 5.5mm,the most of female could accommodate with the screws of 4.5mm,but few women could only accommodate with the screws of 3.5mm.the insert points and insert direction of screws were difference between male and female.The minimum Cross-sections concentric circles diameter couldn’t decide the size of the anterior column screws.The first minimum Cross-section plane was situated between in the anterior inferior spine and the iliopubic eminence.The second minimum Cross-section plane was situated between in the iliopubic eminence and the superior ramus of pubis.(3).digital anatomy provides a new technology to orthopaedics anatomy,this new technology has widely applied prospect in clinical practice. |
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