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Digital Anatomy to Improve Screw Insertion Techniques for Plate-Screw Fixation of the Pubic Body
OBJECTIVES: This study aims to investigate screw insertion sites on the pubic body and the safe screw insertion parameters of a plate-screw fixation system based on the premise of avoiding damage to the inguinal canal and disruption of the rectus abdominis at the pubic symphysis and pubic crest. RES...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311337/ https://www.ncbi.nlm.nih.gov/pubmed/30643807 http://dx.doi.org/10.1155/2018/4690879 |
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author | Li, Wenlong Zhao, Futing Sun, Zhaoyun Wang, Xing Gao, Shenglong Xu, Bo Mu, Weidong |
author_facet | Li, Wenlong Zhao, Futing Sun, Zhaoyun Wang, Xing Gao, Shenglong Xu, Bo Mu, Weidong |
author_sort | Li, Wenlong |
collection | PubMed |
description | OBJECTIVES: This study aims to investigate screw insertion sites on the pubic body and the safe screw insertion parameters of a plate-screw fixation system based on the premise of avoiding damage to the inguinal canal and disruption of the rectus abdominis at the pubic symphysis and pubic crest. RESEARCH METHODS: Excluding cases with poor image quality, tumors, malformations, and fractures, the data of 80 healthy adults (40 males and 40 females aged from 21 to 83 years old, with an average age of 51.65 years) undergoing a computed tomography (CT) scan of the pelvis between January and June of 2017 were collected from Shandong Provincial Hospital. The CT scans were imported to Mimics® software to reconstruct three-dimensional pelvic models. A 3.5 mm pelvic reconstruction plate was placed starting at the outer edge of the pubic tubercle and along the pelvic brim. The two innermost screw insertion sites were marked. The safe range for the screw insertion sites was then determined. The screw insertion plane was selected to measure the safe screw insertion parameters. The length of the screw, the direction of insertion, and intersex differences were then explored via statistical analyses. RESULTS: The medial inclination angles (MIAs) of the screw insertion plane for males and females were 30.42±7.95° and 32.88±10.65°, respectively, with no statistically significant differences. For the medial screw, the maximum anterior inclination angle (MAIA), the maximum screw length, and the maximum posterior inclination angle (MPIA) were 46.51±4.01°, 12.40±9.53 mm, and 11.78±10.22° on average, respectively, with no significant differences by gender (P>0.05). For the lateral screw, the MAIA was 10.35±9.46° and showed no gender differences (P>0.05), but the male group had a greater MPIA (male 11.80±11.00° vs. female 6.23±7.91°, P<0.05) and maximum screw length (male 55.71±6.36 mm vs. female 48.68±8.65, P<0.001). For the tangential screw, the maximum screw length, MIA, and anterior/posterior inclination angle (APIA) were 52.19±8.33 mm, 31.65±9.42°, and 7.53±10.18°, respectively, with no significant differences in the angles by gender (both P>0.05), although the screw length in the male group was significantly longer than that in the female group. CONCLUSIONS: Insertion of two screws into the pubic body through a plate from the lateral side of the pubic tubercle is safe and can maintain the origin of the rectus abdominis and the integrity of the inguinal canal compared to traditional plate-screw fixation. Considering that the pubic body is thinner on the lateral side, we suggest a more medial inclination angle for the lateral screw. |
format | Online Article Text |
id | pubmed-6311337 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-63113372019-01-14 Digital Anatomy to Improve Screw Insertion Techniques for Plate-Screw Fixation of the Pubic Body Li, Wenlong Zhao, Futing Sun, Zhaoyun Wang, Xing Gao, Shenglong Xu, Bo Mu, Weidong Biomed Res Int Research Article OBJECTIVES: This study aims to investigate screw insertion sites on the pubic body and the safe screw insertion parameters of a plate-screw fixation system based on the premise of avoiding damage to the inguinal canal and disruption of the rectus abdominis at the pubic symphysis and pubic crest. RESEARCH METHODS: Excluding cases with poor image quality, tumors, malformations, and fractures, the data of 80 healthy adults (40 males and 40 females aged from 21 to 83 years old, with an average age of 51.65 years) undergoing a computed tomography (CT) scan of the pelvis between January and June of 2017 were collected from Shandong Provincial Hospital. The CT scans were imported to Mimics® software to reconstruct three-dimensional pelvic models. A 3.5 mm pelvic reconstruction plate was placed starting at the outer edge of the pubic tubercle and along the pelvic brim. The two innermost screw insertion sites were marked. The safe range for the screw insertion sites was then determined. The screw insertion plane was selected to measure the safe screw insertion parameters. The length of the screw, the direction of insertion, and intersex differences were then explored via statistical analyses. RESULTS: The medial inclination angles (MIAs) of the screw insertion plane for males and females were 30.42±7.95° and 32.88±10.65°, respectively, with no statistically significant differences. For the medial screw, the maximum anterior inclination angle (MAIA), the maximum screw length, and the maximum posterior inclination angle (MPIA) were 46.51±4.01°, 12.40±9.53 mm, and 11.78±10.22° on average, respectively, with no significant differences by gender (P>0.05). For the lateral screw, the MAIA was 10.35±9.46° and showed no gender differences (P>0.05), but the male group had a greater MPIA (male 11.80±11.00° vs. female 6.23±7.91°, P<0.05) and maximum screw length (male 55.71±6.36 mm vs. female 48.68±8.65, P<0.001). For the tangential screw, the maximum screw length, MIA, and anterior/posterior inclination angle (APIA) were 52.19±8.33 mm, 31.65±9.42°, and 7.53±10.18°, respectively, with no significant differences in the angles by gender (both P>0.05), although the screw length in the male group was significantly longer than that in the female group. CONCLUSIONS: Insertion of two screws into the pubic body through a plate from the lateral side of the pubic tubercle is safe and can maintain the origin of the rectus abdominis and the integrity of the inguinal canal compared to traditional plate-screw fixation. Considering that the pubic body is thinner on the lateral side, we suggest a more medial inclination angle for the lateral screw. Hindawi 2018-12-12 /pmc/articles/PMC6311337/ /pubmed/30643807 http://dx.doi.org/10.1155/2018/4690879 Text en Copyright © 2018 Wenlong Li et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Li, Wenlong Zhao, Futing Sun, Zhaoyun Wang, Xing Gao, Shenglong Xu, Bo Mu, Weidong Digital Anatomy to Improve Screw Insertion Techniques for Plate-Screw Fixation of the Pubic Body |
title | Digital Anatomy to Improve Screw Insertion Techniques for Plate-Screw Fixation of the Pubic Body |
title_full | Digital Anatomy to Improve Screw Insertion Techniques for Plate-Screw Fixation of the Pubic Body |
title_fullStr | Digital Anatomy to Improve Screw Insertion Techniques for Plate-Screw Fixation of the Pubic Body |
title_full_unstemmed | Digital Anatomy to Improve Screw Insertion Techniques for Plate-Screw Fixation of the Pubic Body |
title_short | Digital Anatomy to Improve Screw Insertion Techniques for Plate-Screw Fixation of the Pubic Body |
title_sort | digital anatomy to improve screw insertion techniques for plate-screw fixation of the pubic body |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311337/ https://www.ncbi.nlm.nih.gov/pubmed/30643807 http://dx.doi.org/10.1155/2018/4690879 |
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