摘要目的 通过成人尸体髂骨形态解剖学及影像学相关数据的测量与分析,探讨Galveston 固定中最理想的髂骨钉置入路径.方法 保存完好的5具10侧新鲜尸体半骨盆,性别不限.于髂骨Chiotic线上方15 mm处每5 mm平行于该线截骨,直至髋臼上缘.分别测量截骨面髂骨钉置入有效路径长度、峡部位置及内径宽度.50例成人患者(性别不限)行骨盆CT三维重建.分别测量Click点至髂前下棘下缘(A)、髂后上棘至髂前下棘下缘(B)、髂后上棘至髋臼上壁(C)三条路径的有效路径长度,以及峡部内径宽度及峡部与进钉点的距离.结果 与尸体髂骨测量结论一致,影像学测量结果示路径A拥有最长的有效路径长度,男性平均(137±8)mm,女性(130±11)mm.经由路径A、B可支持两枚髂骨钉的置入,两路径均允许置入男性长度100 mm,直径8 mm,女性长度80 mm,直径6～7 mm髂骨钉.结论 相对于传统髂骨钉置入路径,Click点至髂前下棘下缘允许更长髂骨钉的置入而穿破髋臼的风险更小,为Galveston固定中髂骨钉置入最理想路径.

abstractsObjective To describle the satisfactory intrailiac paths in Galveston fixation combined with adult human cadaver and radiology study.Methods Five adult cadavers with 10 hemisectioned pelvises were harvested.Parallelly to the Chiotic line,the bone every other 5 mm till the superior rim of the acetabultim(SRA)observing the morphologic characteristics of each cross-sections of the iliac columns was cut. Fifty consecutive and randomly selected patients were measured using three-dimensional computed tomographic reformations.Three paths'valid bony canal lengths(LVBC),contractions'inner widths and positions were evaluated.Results The Path A with the longest LVBC(137±8)mm in male,(130±11)mm in female was the most satisfactory intrailiac path according to both adult cadaver and radiographic measurement.Path A and B allowed placement of 100 mm and 8 mm implants in male,80 mm and 6 to 7mm implants in female patients.Conclusion The Path A,passing from the Click point towards the bottom of the anterior inferior iliac spine provides a longer and potentially safer anchor site compared with the traditional path.