| Background Holistic View of Traditional Chinese Medicine(TCM)emphasizes the integrity and unity of people,things,and nature."Su Wen · Wu Chang Zheng Da Lun" has a saying viewing man and nature as a whole: "In order to know the fate of people,those who treat the disease will be better at geography,Yin and Yang will be better,the order of Qi,the life of human beings,and time of produce and transportation".It emphasizes that people are an organic whole,and the parts that make up the human body are coordinated and complementary.There is a dialectical unity between the whole and the parts.Part is a part of the whole,and the whole is a part composed of parts.A part can be composed of other "parts" as a whole,and this part and other parts are organically combined to form another whole.Changes in local structure will affect the whole,and changes in the overall structure can also reflect local anomalies.Under the understanding of the holistic concept,the ilium as an entirety is composed of the iliac crest,the iliac wing,and the iliac body.If the innominatum is considered as a whole,the ilium will be "local " part.Each part has different structural forms and functions.They coordinate with each other and serve each other.They are reflected in overall harmony and stability.For example,pelvic acetabular fractures often extend from the acetabulum to the iliac wing.According to the reset principle,when the ilium is reduced,we first reset the ilium.A well-reduced iliac fracture can provide a template for subsequent acetabular fracture reduction.A good acetabular fracture reduction may ensure the good function of the hip joint in the future.This is a good illustration of the internal relationship between the part and the whole.With the rapid development of industry and transportation,the incidence of high-energy pelvic trauma has increased year by year,and the severity and complexity of injuries have become more difficult.Simple iliac fractures are rare,accounting for only2.2% of pelvic fractures,and often coexist with acetabular fractures and pelvic ring fractures.Clinically,the reduction of complex pelvic fractures follows the order from near to far,that is,the reduction of the iliac fracture outside the acetabular area and then the reduction of the acetabular fracture.However,when resetting complex pelvic fractures,only the reduction of acetabular fractures is emphasized,and the quality of reduction of iliac fractures is relatively low.This is not hard to see from the difference between the pelvic fracture and the acetabular fracture Matta evaluation criteria.And we found in the clinic that unsatisfactory iliac reduction will magnify the degree of displacement and rotation of the acetabular fracture,and anatomical reduction of the ilium will help improve the quality of acetabular fracture reduction.Currently,the clinically used Matta evaluation standard for pelvic fractures is emphasized that the local counterpoint but cannot evaluate the alignment such as rotational displacement of the fracture block.This ignores the existence of the pelvis as a whole and often affects the restoration of overall function.However,the shape of the ilium is special,and it is difficult to perform anatomical measurement with conventional methods,so that there is not much relevant data.For this,Xu Yingpeng provided a reference for anatomical reduction of the iliac wing by defining and preliminary measuring the deflection angle of the iliac plane,the angle of inclination of the iliac ala relative to the square region,and the iliac crest arc.In view of the importance of anatomical reduction of iliac fractures,this series of anatomical parameters can bring positive significance to intraoperative reduction and postoperative imaging evaluation,further expansion of the sample size and consideration of geographic conditions may make relevant anatomical data more accurate.Therefore,based on the previous research experience,we selected from parts of China(Central Region: General Hospital of Central Theater Command;Northern Region: General Hospital of Northern Theater Command;Southern Region: Foshan Sanshui District People's Hospital;Western Region: The First Affiliated Hospital of Xinjiang Medical University and No.987 Hospital of PLA in Baoji)pelvic CT scans of the original images of healthy adults,with the digital medical software to establish a three-dimensional model of the pelvic CT and measure various anatomical parameters of the ilium,initially establish a Chinese ilium anatomy database,and provide data support for the anatomical reduction of clinical iliac fractures.Part one Digital measurement and clinical significance of normal adult iliac crest plane deflection Angle in several regions of ChinaObjective The holistic concept of TCM emphasizes the integrity of people,things and nature,which constitutes coordination between the human body and each part.Changes in the local structure will affect the whole,and changes in the overall structure can also reflect local abnormalities.Based on The holistic concept of TCM,a normal iliac structure is the basic premise for its physiological function,and the good reduction of the ilium can provide a correct bony reference for the anatomical reduction of acetabular fractures.Xu Yingpeng defined iliac crest plane deflection angle was very meaningful,but because of the small sample size and large variation of the human metatarsal bone,the results were difficult to be representative.Therefore,on the basis of Xu Yingpeng's research,this study expanded the sample size and included the area into the grouping range.Based on the measurement of the normal adult iliac crest plane deflection angle of the human pelvic diaphragm in the central,southern,northern,and western regions of China,got the overall anatomical parameters of the Chinese,a preliminary database of the horizontal ilium of the Chinese people was established to provide anatomical data support for clinical improvement of iliac fracture reduction quality.Methods A total of 313 cases(602 sides)of pelvic CT scans of healthy adults(?18 years)who underwent CT three-dimensional examination were collected in DICOM format from October 2013 to October 2018 in General Hospital of Central Theater Command,Foshan Sanshui District People's Hospital in the southern region,The First Affiliated Hospital of Xinjiang Medical University and No.987 Hospital of PLA in the western region,General Hospital of Northern Theater Command in the northern region.Of which,89 males(178sides)of the General Hospital of Central Theater Command,aged 18 to 88 years old,average 40.90 years old;58 females(116 sides),aged 19 to 85 years old,average 46.48 years old,all with complete pelvis.From the General Hospital of Northern Theater Command,29males(58 sides),aged 20 to 73 years,mean age: 42.00 years old;12 females(24 sides),aged 21 to 73 years,mean age 54.15 years,all with complete pelvis;Foshan Sanshui District People's Hospital line 46 cases(92 sides),aged 20 to 54 years,with an average age of 30.52 years old;39 cases(78 sides),females,aged 22 to 64 years,with an average age of 39.15 years,all had complete pelvis;the First Affiliated Hospital of Xinjiang Medical University male 14cases(16 sides),2 cases complete There were 5 cases of left pelvis,7 cases of right pelvis,aged 20 to 74 years,mean age 40.62 years;4 cases of female(4 sides),2 cases of left pelvis,2 cases of right pelvis,aged 27 to 54 years,The average age was 43.25 years old;12 males(19 sides)in No.987 Hospital of PLA,7 intact,1 left pelvis,4 right pelvis;10 females(17 sides),7 intact,and 0 left pelvis 3 cases of right pelvis.Mimics 20.0 and Geomagic Studio 12.0software were used to perform 3D reconstruction and projection of all pelvic CT data,measured the iliac crest plane deflection angle,and initially established a database of Chinese anatomical parameters,and tried to compare and analyze data between regions.Results The horizontal plane of iliac crest was similar to "S" curved asymmetry.The overall situation of Chinese people:the deflection angle of the anterior central parts,(132.45 ± 8.87)°(102.44°~157.54°),the central posterior parts,(145.62±7.05)°(121.71°~166.80°).Central area measurement results,the angle of the anterior central parts,male:(130.92±9.90)°(102.44 °~153.49 °),female:(132.07±8.77)°(109.51 ° ~ 148.86 °);Middle and rear deflection angle,male:(143.44±7.04)°(129.83 °~159.11 °),female:(144.08±7.32)°(127.70 °~157.73 °).southern area measurement results: front middle deflection angle,male:(133.69±7.39)°(116.88 °~146.52 °),female:(133.42±7.32)°(113.26 °~146.56 °);middle and rear deflection angle,male:(148.51±5.52)°(134.89 °~160.86 °),female:(148.05±5.83)°(138.80 ° ~ 162.53 °).Measurement results in the north area: front deflection angle,male:(134.28±8.58)°(121.64 °~157.54 °),female:(136.17±8.75)°(121.42 °~152.10 °);middle and rear deflection angle,male:(146.68±7.80)°(125.81 °~163.56 °),female:(149.20±6.55)°(141.46 °~166.80 °).Measurement results in the western region:Xinjiang front deflection angle,(134.41 ± 9.86)°(118.11 ° ~150.32 °),female:(140.24±6.74)°(131.83 °~ 147.84 °);middle and rear deflection angle,male:(144.77±7.97)°(129.34 °~158.88 °),female:(152.35±2.56)°(149.65 °~154.72 °).deflection angle of the middle part of the horizontal position of the ilium in Baoji area,male:(128.61±8.71)°(114.62 °~148.34 °),female:(129.04±8.30)°(118.24 °~148.72 °);middle and rear deflection angle,male:(145.03±4.87)°(136.48 ° ~ 152.26 °),female:(143.19±6.50)°(131.72 °~ 153.87 °).The deflection angle of the anterior central part(132.45°)was significantly smaller than that of the central posterior part(145.62°),and the difference was statistically significant(central,southern,northern,and western regions)(P<0.05).There was no significant difference in the left and right data of the same sex(central,southern,and northern regions)(P>0.05).There was no statistically significant difference between male and female deflection angles in the front and middle deflection angles(middle,southern,and northern regions)(P > 0.05).The measurement results in the middle area were the front middle deflection angle of the horizontal plane(131.37±9.47)° and the middle rear deflection angle(143.69±7.15)°.The measurement results in the southern area were the front middle deflection angle of the horizontal plane(133.57±7.34)° and the middle rear deflection angle(148.30±5.65)°.The measurement results in the north area were the front middle deflection angle of the horizontal plane(134.83 ± 8.62)° and the middle rear deflection angle(147.42±7.51)°.In the comparison of the data of the central,southern and northern regions,the differences in the deflection angles of the front middle and middle posterior were statistically significant(P < 0.05).In the difference between the front deflection angle and the rear deflection angle,there was no statistically significant difference between the results of the southern and northern regions(P > 0.05),and there were statistically significant differences in the results of the central and southern regions,and the central and northern regions(P<0.05).This parameter could quantitatively describe the iliac crest plane morphology of the pelvic iliac level in Chinese people,made up for the gap in the description of the iliac wing morphology data previously,and provided a data reference for the reduction of the iliac fracture and the shaping of the internal fixation.It could provide data support for the evaluation of postoperative iliac fracture rotation displacement and made up for the deficiency of the pelvic Matta standard.Conclusion The horizontal plane of the iliac crest of healthy adults is curved in an “S” shape,and the deflection angle of the anterior middle part(132.45°)is obviously smaller than the deflection angle of the middle and posterior part(145.62 °).The quantification of the iliac crest deflection angle quantifies the entire iliac crest S-shaped bend,which effectively interprets the relationship between the part and the whole,which is in line with the overall view of TCM.There is no statistically significant difference in the horizontal deflection angles of the iliac crest plane diaphragm of adults in the central,southern,and northern regions with the left and right sides of the same sex,and between males and females.The deflection angles of the front and middle areas are 132.45 ° on average,the average area of the central area is 131.37 °,the average area of the southern area is 133.57 °,and the average area of the northern area is 134.83 °.The regional results are statistically different;the deflection angle of the middle and rear areas is generally 145.62 °,the average of the central area is 143.69 °,the average of the southern area is148.30 °,and the average of the northern area is 147.42 °.The results of the central region are statistically different from those of the other two regions.This parameter can quantitatively describe the iliac morphology of the pelvic iliac level in Chinese people,make up for the gap in the description of the iliac wing morphology data previously,and provide a data reference for the reduction of the iliac fracture and the shaping of internal fixation.Rotational displacement of the posterior metatarsal fracture provides data support to make up for the deficiency of the pelvic Matta standard.Part two Digital measurement and clinical significance of adult angle of inclination of the iliac ala relative to the quadrilateral region and the iliac crest radian in several regions of ChinaObjective Based on the holistic concept,the ilium,as a local manifestation of the hip bone,has its own anatomical characteristics.There is also a corresponding anatomical relationship between the ilium and the acetabular square area.We should not treat the two as splits.We should treat the two as two parts of the whole while paying attention to the ilium,and treat the anatomical relationship from a holistic perspective.The first part obtained the deflection angle of the Chinese iliac crest horizontal plane.In this part,we continue to measure the anatomical parameters of the inner and outer sides of the ilium.The angle of inclination of the iliac ala relative to the square region(inclination angle of ilium to quadrilateral area,INIQ)and the iliac crest radian in the central,southern,northern,and western regions are clarified,get the total anatomical parameters of the Chinese and a database of anatomical parameters of the inside and outside of the ilium of the Chinese was initially established.The anatomical shape of the ilium reflected the value of the overall view to provides more accurate anatomical parameters for improving the reduction quality of the iliac and pelvic acetabular fractures.Methods A total of 313 cases(602 sides)of pelvic CT scans of healthy adults(?18 years)who underwent CT three-dimensional examination were collected in DICOM format from October 2013 to October 2018 in General Hospital of Central Theater Command,Foshan Sanshui District People's Hospital in the southern region,The First Affiliated Hospital of Xinjiang Medical University and No.987 Hospital of PLA in the western region,General Hospital of Northern Theater Command in the northern region.Of which,89 males(178sides)of the General Hospital of Central Theater Command,aged 18 to 88 years old,average 40.90 years old;58 females(116 sides),aged 19 to 85 years old,average 46.48 years old,all with complete pelvis.From the General Hospital of Northern Theater Command,29males(58 sides),aged 20 to 73 years,mean age: 42.00 years old;12 females(24 sides),aged 21 to 73 years,mean age 54.15 years,all with complete pelvis;Foshan Sanshui District People's Hospital line 46 cases(92 sides),aged 20 to 54 years,with an average age of 30.52 years old;39 cases(78 sides),females,aged 22 to 64 years,with an average age of 39.15 years,all had complete pelvis;the First Affiliated Hospital of Xinjiang Medical University male 14cases(16 sides),2 cases complete There were 5 cases of left pelvis,7 cases of right pelvis,aged 20 to 74 years,mean age 40.62 years;4 cases of female(4 sides),2 cases of left pelvis,2 cases of right pelvis,aged 27 to 54 years,The average age was 43.25 years old;12 males(19 sides)in No.987 Hospital of PLA,7 intact,1 left pelvis,4 right pelvis;10 females(17 sides),7 intact,and 0 left pelvis 3 cases of right pelvis.Mimics 20.0 and Geomagic Studio 12.0software were used to perform 3D reconstruction and projection of all pelvic CT data,measured the iliac crest plane deflection angle,and initially established a database of Chinese anatomical parameters,and tried to compare and analyze data between regions.Results Adult INIQ: The overall situation of the Chinese: the inclination of the front part:(141.68 5.52)°(125.72~156.75)°,the middle:(129.26±6.03)°(107.85 ~ 146.18)°,the rear:(101.33±4.95)°(85.11~116.25)°.Central area: front tilt angle,male:(142.78±5.89)°(133.16° ~ 155.12°),female:(141.78±5.07)°(132.20 °~154.42 °);middle tilt angle,male:(131.19±5.95)°(115.68 ° ~ 143.35 °),female:(127.04±5.80)°(111.90 °~141.69 °);rear tilt angle,male:(102.00±5.26)°(86.70 ° ~ 113.95 °),female:(101.25±5.05)°(87.31°~111.67°).Southern area: front tilt angle,male:(141.30±4.50)°(133.65 °~ 152.74 °),female:(140.41±3.83)°(133.00°~150.66 °);middle tilt angle,male:(131.06±4.21)°(121.34° ~ 136.91°),female:(127.25±5.38)°(110.60° ~ 139.81°);INIQ of male:(101.36±3.94)°(93.91°~111.20 °),female:(101.13±4.88)°(88.09 ° ~ 109.20 °).North area: front tilt angle,male:(142.29±6.66)°(129.48°~155.82°),female:(142.09±5.00)°(130.48°~150.98°);middle tilt angle,male:(130.19±6.19)°(115.51° ~ 141.75°),female:(129.51±4.25)°(121.09° ~137.50°);rear tilt angle,male:(101.25±4.68)°(88.43° ~111.16°),female:(104.87±4.12)°(96.52°~ 109.62°).Western region: Xinjiang region: front tilt angle,male:(136.42±6.49)°(128.78° ~ 148.77°),female:(137.25±7.35)°(129.38° ~146.74°);central tilt angle,male:(124.11±9.02)°(107.85° ~141.51°),female:(123.37±7.78)°(114.50° ~ 133.23°);rear tilt angle,male:(96.97±6.64)°(85.11°~110.95°),Female:(101.59±5.78)°(95.71°~109.55 °);Baoji area: front tilt angle,male:(139.99±7.05)°(130.76° ~ 155.93°),female:(142.70±5.35)°(133.97°~150.78°);middle tilt angle,male:(127.77±6.47)°(116.83°~140.64°),female:(127.91±5.97)°(120.40° ~ 140.73°);rear tilt angle,male:(98.13±4.90)°(89.35 ° ~ 106.72°),female:(99.53±3.29)°(96.17° ~105.43°).There was no significant difference in the left and right inclination angles of the adult pelvis in same sex(central,southern,northern,and Baoji regions)(P> 0.05).The inclination angles gradually decreased from front to back,and there were significant differences between the inclination angles in the front,middle and rear regions(P<0.05).There was no statistically significant difference between the male and female tilt angles in the central and southern regions(P > 0.05),and there was a significant difference between the genders in the central inclination angles(P<0.05);the central inclination angle was male> female;There was no statistical difference between the male and female at the middle and middle inclination angles(P>0.05),and there was a statistical difference between the male and female at the posterior inclination angle(P<0.05).Men were smaller than women.Because the differences in the front,middle,and back inclination angles between regions were different between the male and female,the two sexes were compared separately when comparing regions(the same for the iliac crest radian in each region).Results by region: Male: central region,front tilt angle:(142.78±5.89)°,central tilt angle:(131.20±5.95)°,rear tilt angle:(102.00±5.26)°;southern region,front tilt Angle:(141.30±4.50)°,middle tilt angle:(131.06±4.21)°,rear tilt angle:(101.36±3.94)°;northern area,front tilt angle:(142.29±6.66)°,middle tilt angle :(130.19±6.19)°,rear tilt angle:(101.69±4.82)°.Female: central region,front tilt angle:(141.78±5.07)°,central tilt angle:(127.04±5.80)°,rear tilt angle:(101.25±5.05)°;southern region,front tilt angle:(140.41±3.83)°,middle tilt angle:(127.25±5.38)°,rear tilt angle:(101.13±4.88)°;northern area,front tilt angle:(142.10±5.00)°,middle tilt angle:(129.51±4.25)°,rear tilt angle:(104.04±3.23)°.There was no statistically significant difference between the central,southern and northern regions in men's INIQ(P > 0.05).There was no statistically significant difference in the angles of the front,middle for female between the central,southern,and northern regions(P>0.05);for the back inclination angle of female,there was a statistically significant difference in the data of the three regions(P<0.05).There was no statistically significant difference between the central region and the southern region(P > 0.05),there was a statistically significant difference between the central region and the northern region(P < 0.05),and there was a statistically significant difference between the southern region and the northern region(P<0.05).In terms of iliac crest radian,the overall situation of the Chinese: full iliac crest radian(rad): 3.01±0.16(2.28~3.39),the anterior central inner part(rad): 2.17±0.19(1.48~2.75),the posterior external part: 1.50±0.29(0.53~2.22);central area:full radian(rad),male: 3.06±0.15(2.65 ~ 3.38),female:2.89±0.13(2.66~3.23);the anterior central inner part(rad),male: 2.26±0.19(1.88~2.71),female: 2.10±0.18(1.69~2.47);the posterior external part(rad),male: 1.43±0.29(0.60~1.81),female: 1.44±0.28(0.62~1.86);southern area: full radian(rad),male: 3.10±0.11(2.85~3.33),female: 2.90±0.14(2.54~3.27);the anterior central inner part(rad),male: 2.13±0.14(1.83~2.45),female: 2.04±0.18(1.65~2.40);the posterior external part,Male:1.47±0.25(0.95~1.94),female: 1.62±0.28(0.80~2.20).there was no difference in adult pelvis(center,south,north,and Baoji areas)of the same sex on the left and right full Iliac Crest radians,the anterior central inner part and the posterior external part(P>0.05).There was no significant difference between the sexes of the middle and northern regions of the mid-rear palatal outer lip arc(P>0.05).The difference was statistically significant(P<0.05).Men were larger than women.In the southern region,the differences between the three radians of the entire iliac radian,the radian of the inner lip of the middle and posterior lip,and the radian of the lip of the middle and posterior lip were statistically significant.Significance(P<0.05),both men were larger than women.Results by Region: male: Central Region,full iliac crest radian(rad): 3.06±0.15;the anterior central inner part(rad):2.26±0.19;the posterior external part(rad): 1.43±0.29.In the southern region,the total radian(rad): 3.10±0.11;the anterior central inner part(rad):2.14±0.14;the posterior external part:1.47±0.25.In the northern region,the total radian(rad):3.10±0.11;the anterior central inner part: 2.22±0.19;the posterior external part: 1.61 ± 0.23.Female: in the central region,the total radian(rad): 2.89±0.13;the radian(rad)of the anterior central inner part: 2.10±0.18;the posterior external part(rad):1.44±0.28;In the southern region,the total radian(rad):2.90±0.14;the radian(rad)of the anterior central inner part:2.04±0.18;the posterior external part: 1.62±0.28.In the northern region,the total radian(rad): 2.93±0.14;the anterior central inner part(rad): 2.12±0.17;the radian(rad)of the posterior external part: 1.58±0.28.Comparing results between regions,male: no statistical difference was found in the data of men's full iliac crest radian in the central,southern,and northern regions(P>0.05);comparison of the anterior central inner part and the posterior external part,the difference was statistically significant(P<0.05).Among them,the difference in the anterior central inner iliac crest radians between the central and northern regions was not statistically significant(P > 0.05).The difference between the southern region and the central region was statistically significant(P<0.05).The southern region and the northern region were significantly different.There was statistical significance(P<0.05);the posterior external part was not statistically significant compared with the central and southern regions(P>0.05),and the difference between the northern and central regions was statistically significant(P<0.05),there was a statistically significant difference between the northern region and the southern region(P<0.05).The average value of the anterior central inner part was 0.12 rad larger than that in the south,and 0.08 rad was larger in the north region than the southern region;The average radian of the posterior external part was 0.18 rad larger in the north than in the middle,and 0.15 rad larger in the north than in the south.For female: women's full iliac crest radian,there was no statistically significant difference in data between the central,southern and northern regions(P>0.05);There was a statistically significant difference in anterior central inner part and the posterior external part(P<0.05).among them,there was no significant difference in the anterior central inner part between the central and northern regions,the same as between the southern and northern regions(P > 0.05).There was a significant difference between the central and southern regions(P<0.05).The posterior external iliac crest radian,there was no significant difference between the central and northern regions(P>0.05).There was a significant difference between the central and southern regions,the same as between the southern and central regions(P>0.05).The average radian of the anterior central inner part in the central region was 0.06 rad larger than that in the south;the average radian of the posterior external part in the southern region was 0.18 rad larger than in the central region.In this study,a database of anatomical parameters of the sagittal plane of the ilium was initially established.This parameter could quantitatively describe the morphology of the sagittal plane of the ilium of the Chinese people.Together with the horizontal plane of the iliac crest of the first part,it could make up for the lack of description of the iliac morphology data it could provide data reference for clinical reduction and shaping of internal iliac fractures.Conclusion The angle of inclination of the iliac ala of the adult is in an outwardly inclined state,and the INIQ(front:(141.68±5.52)°,middle:(129.26±6.03)°,rear:(101.33±4.95)° Initially quantifies the degree of its inclination,front inclination angle> middle inclination angle> rear inclination angle.There is no significant difference in the left and right tilt angles of the same-sex adult pelvis in different regions.The quantification of the INIQ quantifies the Inclination of the iliac wing inner plate and square area,which effectively interprets the relationship between the part and the whole,which is in line with the overall view of TCM.The inner lip of the entire iliac crest,the front and middle inner iliac crest,and the outer lip of the middle and posterior iliac crest are curved in a curved shape,but their respective curvatures are different.There is no significant difference in the total radian,the radian of the inner middle lip and the radian of the middle and posterior lip.These data provide anatomical data for iliac reduction and internal fixation,and a preliminary database is established.Part three Preliminary application of the tilt angle to evaluate reduction quality of the iliac fracture of postoperative acetabular double column fracturesObjective Based on the holistic theory of TCM,acetabular fractures often involve fractures in other parts of the pelvis.The quality of reduction in other parts of the fracture will affect the quality of reduction of acetabular fractures.Therefore,we cannot only focus on the reduction of acetabular fractures and ignore fractures other than acetabular fractures.As shown in Chapter 2 of this study,the square area to which the ilium is connected also constitutes a partial and overall relationship.In this study,the pelvic Matta evaluation standard and the pelvic Matta evaluation standard + INIQ were used to evaluate the reduction quality of iliac fractures in double-column fractures to compare the reduction quality of their respective acetabular fractures.The distribution of good and bad distributions was used to evaluate the feasibility of INIQ for evaluating the quality of iliac reduction after pelvic and acetabular fractures affecting the ilium.Methods A retrospective analysis of the data of 50 patients admitted to the General Hospital of Central Theater Command from January 2013 to May 2019;31 males and 19 females;aged 21 to 65 years,with an average age of 47.3 years;males were left there were 15 cases on the right side and 16 on the right side;7 cases on the left side and 12 cases on the right side.All fractures were closed fractures,and high double-column fractures according to the Letournel-Judet classification criteria.The time from injury to surgery was 3-20 days,with an average of 8.2 days.All patients were treated via the ilioinguinal approach with internal fixation with the technique of DAPSQ combined iliac wing medial plate fixation.the short plate fixation on the inner side of the iliac wing was used when necessary.All patients had a three-dimensional pelvic CT review after surgery.In this study,50 cases of ilium and acetabulum were evaluated by the corresponding Matta standard.The results of different grades of evaluation were measured by INIQ.To understand the distribution of superior,good,and poor quality of acetabular reduction measured by the single Matta standard and Matta standard + INIQ,and analyzed the results.Results The pelvic Matta criteria were evaluated as 68 cases with good results,15 cases with good results,and 6 cases with poor results.the pelvic Matta evaluation standard + INIQ were 22 cases with excellent results,53 cases with good results,and 14 cases with poor results.There were 68 cases of excellent pelvic Matta standard,28 had excellent acetabular reduction quality,31 were good,9 were poor,and the excellent and good rate was 86.76%.Among the 22 patients with the pelvic Matta evaluation standard + INIQ,17 had excellent acetabular reduction quality and 4 were good.Cases,1case was poor,the excellent and good rate was 95.45%.There were15 cases of good pelvic Matta criteria,3 had good acetabular reduction quality,5 had good results,and 7 had poor results.The excellent and good rate was 53.33%.Among the 53 patients with the pelvic Matta evaluation standard + V,14 had good acetabular reduction quality and good 34,there were 5 cases with poor results,and the excellent and good rate was 92.45%.There were 6 cases of poor pelvic Matta criteria,the quality of acetabular reduction was excellent in 1 case,good in 3 cases,and poor in 2 cases,with a poor rate of 33.33%.Among the 14 cases with the pelvic Matta evaluation standard + INIQ standard,the quality of acetabular reduction was excellent in 1 case,good 1 case,12 cases were poor,and the poor rate was 85.71%.The cases with excellent and good acetabular reduction were scattered among the excellent,good,and poor cases evaluated by the pelvic Matta criteria,and concentrated in the excellent and good cases evaluated by the pelvic Matta evaluation standard + INIQ criteria.The pelvic Matta criteria evaluated as excellent,good,and poor cases were scattered,but concentrated in the pelvic Matta evaluation standard + INIQ criteria as poor cases.There was a statistically significant difference in the distribution of acetabular mass between the two(P <0.05).Conclusion INIQ combined with the pelvic Matta standard can significantly improve the accuracy of using the Matta evaluation standard to reduce acetabular fractures and iliac fractures,which makes up for the Matta standard's inability to evaluate the rotation of the iliac fracture after reduction.The results should prove the scientificity of the TCM holistic view,suggesting that the relative relationship between local and overall should be emphasized in clinical treatment.At the same time,it has been proved that the inclination of the iliac wing inner plate relative to the square area is one of the important parameters of the anatomical structure of the ilium,and the awareness of the importance of ilium reduction during the treatment of acetabular fractures should be improved. |
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