Anatomic study on the measurement of track length of dynamic anterior plate-screw system
Shang Ranran1, Song Chengjing1, Wu Haiyang2, Cai Xianhua1,2
1First Clinical College, Hubei University of Chinese Medicine,Wuhan 430061, China; 2Department of Orthopedics, General Hospital of Central Theater Command , Clinical Medical Research Center of Bone Trauma in Hubei Province, Wuhan 430070, China
Abstract：Objective To explore the feasibility and clinical significance of the the trajectory length measurement of the dynamic anterior plate-screw system for quadrilateral area (DAPSQ), and to provide a method for measuring the trajectory length of DAPSQ plate and the proportion of each region.Methods The DAPSQ plate trajectory was drawn on 14 adult dry pelvis specimens (22 sides) without deformity or bone defect. Then, PDS suture was placed along the DAPSQ plate trajectory and marked each area. The length of the pubic region, quadrilateral surface region and tibia region were measured by vernier calipers.Then, the measured pelvis was scanned by CT and reconstructed in three dimensions to get DICOM format data, which was imported into the software of Mimics 20.0. Each partition was regarded as a part of the circle, the diameter of each circle and the corresponding chord length of each partition were measured respectively. According to the formula, the digital measurement length of the DAPSQ plate trajectory in the pubic region, square region, and sacrum region was calculated respectively. The intraclass correlation coefficient(ICC)was used to analyze the consistency between the two measurers. The paired T-test was used to compare the differences between the two measurement methods, and the Bland-Altman test was used to analyze the consistency between the two measurement methods.Results The track length of DAPSQ plate was (60.60±3.79) mm in pubic region, (67.48±4.63) mm in square region and (88.20±6.03) mm in sacrum region. The measured values of specimens were (60.38±3.90) mm in pubic region, (66.08±3.19) mm in square region and (89.19±4.38) mm in sacrum region. The paired t-test showed that there was no significant difference (all P values＞0.05). The ICC of the two measurements were both greater than 0.8, and both were excellent. Bland-Altman analysis showed that except for the difference of 4.5% (1/22) measured by the two methods in the iliac region, the other differences were within the 95% consistency limit, with good consistency (all P values＞0.05).Conclusions The method of digital measurement of DAPSQ track length is reliable, which can provide a feasible imaging measurement method for large data measurement of DAPSQ track length, and provide anatomical reference support for the standardization of DAPSQ plate.
尚冉冉, 宋成璟, 吴海洋, 蔡贤华. 前路动力化方形区钛板螺钉系统钢板轨迹长度测量的解剖学研究[J]. 中华解剖与临床杂志, 2020, 25(1): 31-36.
Shang Ranran, Song Chengjing, Wu Haiyang, Cai Xianhua. Anatomic study on the measurement of track length of dynamic anterior plate-screw system. Chinese Journal of Anatomy and Clinics, 2020, 25(1): 31-36.
蔡贤华, 刘曦明, 汪国栋, 等. 前路钛板结合方形区螺钉内固定治疗涉及方形区的髋臼骨折[J]. 中华创伤骨科杂志, 2013, 15(2): 102-106. DOI:10.3760/cma.j.issn.1671-7600.2013.02.003.Cai XH, Liu XM, Wang GD, et al. Quadrilateral plate fractures of the acetabulum treated by internal fixation with reconstruction titanium plate combined with trans-plate quadrilateral screws via the ilioinguinal approach[J]. Chin J Orthop Trauma, 2013, 15(2): 102-106. DOI:10.3760/cma.j.issn.1671-7600.2013.02.003.
[2]
王正坤. 动力化前路方形区钛板螺钉系统治疗髋臼方形区骨折安全置钉的数字化测量研究[D]. 广州: 南方医科大学, 2016.Wang ZK. Digital measurement research on safe screw insertion in the treatment of acetabular fractures involving the quadrilateral plate using dynamic anterior plate-screw system for quadrilateral area[D]. Guangzhou: Southern Medical University, 2016.
[3]
王正坤, 蔡贤华, 兰生辉, 等. 髋臼方形区安全置钉的数字化测量研究[J]. 中国矫形外科杂志, 2016, 24(8): 739-744. DOI:10.3977/j.issn.1005-8478.2016.08.14.Wang ZK, Cai XH, Lan SH, et al, Digital measurement of safe screw placement in the quadrilateral plate of the acetabulum[J]. Orthopedic Journal of China, 2016, 24(8): 739-744. DOI: 10.3977/j.issn.1005-8478.2016.08.14.
[4]
Arlt S, Noser H, Wienke A, et al. Secure corridor for infraacetabular screws in acetabular fracture fixation-a 3-D radiomorphometric analysis of 124 pelvic CT datasets[J]. J Orthop Surg Res, 2018, 13(1): 119. DOI:10.1186/s13018-018-0833-y.
[5]
Kilinc CY, Acan AE, Gultac E, et al. Treatment results for acetabulum fractures using the modified stoppa approach[J]. Acta Orthop Traumatol Turc, 2019, 53(1): 6-14. DOI:10.1016/j.aott.2018.11.003.
[6]
刘云鹏, 姜俊杰, 孙瑞敏, 等. 解剖型髋臼三维重建钢板的研制与临床应用[J]. 中华创伤杂志, 2003, 19(9): 559-561. DOI:10.3760/j:issn:1001-8050.2003.09.013.Liu YP, Jiang JJ, Sun RM, et al. Development and clinical application of anatomic acetabulum 3D reconstruction plate[J]. Chin J Trauma, 2003, 19(9): 559-561. DOI: 10. 3760/j:issn:1001-8050.2003. 09.013.
[7]
Tannast M, Keel M, Siebenrock KA, et al. Open reduction and internal fixation of acetabular fractures using the modified stoppa approach[J]. JBJS Essent Surg Tech, 2019, 9(1): e3. DOI:10.2106/JBJS.ST.18.00034.
[8]
谷诚. 金属3D打印个性化髋臼翼状接骨板的研发及实验研究[D]. 广州: 南方医科大学, 2017.Gu C. Reasearch of metal 3D printing personalized wing-plate for complex acetabulum fracture[D]. Guangzhou: Southern Medical University, 2017.
[9]
陈忠恒, 刘丰春. 与内固定器设计有关的髋骨弓状线的测量和计算[J]. 解剖学杂志, 2007, 30(4): 472-473. DOI:10.3969/j.issn.1001-1633.2007.04.023.Chen ZH, Liu FC. Calculation and measurement of arcuate line of hipbone concerning design of its internal fixation device for fractures[J]. Chinese Journal of Anatomy, 2007, 30(4): 472-473. DOI: 10.3969/j.issn.1001-1633.2007.04.023.
[10]
王辉, 毕大卫, 胡钢锋, 等. 自制三维解剖锁定钢板固定复合型髋臼骨折的解剖学研究[J]. 中国骨伤, 2013, 26(2): 149-152. DOI:10.3969/j.issn.1003-0034.2013.02.017.Wang H, Bi DW, Hu GF, et al. Anatomical study on the treatment of complex acetabular fractures with self-disigned 3-dimensional anatoimical locking plate[J]. China J Orthop Trauma, 2013, 26(2): 149-152. DOI:10.3969/j.issn.1003-0034.2013.02.017.
[11]
张志光, 还一平, 曹成福, 等. 国人锁骨中远端三维解剖研究及其内固定置入后的影响[J]. 中国矫形外科杂志, 2011, 19(2): 123-126. DOI:10.3977/j.issn.1005-8478.2011.02.10.Zhang ZG, Huan YP, Cao CF, et al. Three-dimensional geometry of the middle and distal part of clavicle in Chinese and the influence after internal fixation and surgical technique[J]. Orthopedic Journal of China, 2011, 19(2): 123-126. DOI: 10.3977/j.issn.1005-8478.2011.02.10.
[12]
郑金洋, 任志勇, 张国梁, 等. 中国蒙古族正常人胫骨近端截骨面数字化形态学特征[J]. 中国组织工程研究, 2017, 21(27): 4348-4353. DOI:10.3969/j.issn.2095-4344.2017.27.015.Zheng JY, Ren ZY, Zhang GL, et al. Anatomical characters of the proximal tibial osteotomy in healthy Mongolia populations[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(27): 4348-4353. DOI:10.3969/j.issn.2095-4344.2017.27.015.
[13]
蔡贤华, 吴咏德, 刘曦明, 等. 前路钛板加方形区螺钉治疗髋臼双柱骨折的站立位力学分析[J]. 中国矫形外科杂志, 2013, 21(6): 595-601. DOI:10.3977/j.issn.1005-8478.2013.06.16.Cai XH, Wu YD, Liu XM, et al. Experimental biomechanical analysis of standing position in both-column acetabular fractures fixed by anterior reconstruction plate combinated with trans-plate quadrilateral screws[J].Orthopedic Journal of China, 2013, 21(6): 595-601. DOI:10.3977/j.issn. 1005-8478.2013.06.16.
2020, Vol. 25 
