Objective
Based on images of pelvic CT three-dimensional reconstruction, to establish three-dimensional coordinate system of pelvis and investigate the three-axis displacement classification of pelvic fracture and its reduction principles.
Methods
Between June 2015 and May 2016, 21 cases of normal pelvic CT data were included in the study, and the mean pelvic three-dimensional model was established. The pelvic three-dimensional axis was established by defining the origin as the midpoint of the anterior superior iliac spine. Based on this coordinate system, a three-axis displacement classification of pelvic fracture were built. To assess the clinical guidance value of the three-axis classification, 55 cases (29 males and 26 females, aged 11-66 years with an average of 35.6 years) of pelvic fractures were analyzed by this classification, and replaced and fixed according to the principles of the reverse reduction.
Results
According to the theory of three-axis, pelvic fractures were divided into x-axis positive displacement/negative displacement, positive rotation/negative rotation; y-axis positive displacement/negative displacement, positive rotation/negative rotation; z-axis positive displacement/negative displacement, positive rotation/negative rotation. The average incision of included patients with pelvic fractures was 7.1 cm. The average reduction time was 12.2 minutes and the average radiation time was 55.3 s. The average time of screw implantation was 27.2 minutes. Postoperative pelvic X-ray films or three-dimensional CT showed all pelvic fracture was reducted well and the screw or plate was implanted correctly. The average intraoperative blood loss was 96.5 mL, the average operation time was 2.1 hours, and the average hospitalization time was 18.7 days. All patients were followed up 6-53 months (mean, 16.7 months). At last follow-up, according to Matta standard by pelvic radiography evaluation, there were excellent in 39 cases, good in 13 cases, and fair in 3 cases, the excellent and good rate was 94.55%.
Conclusion
Based on three-dimensional coordinate system, three-axis displacement classification of pelvic fracture can illustrate the displacement mode of patient simply and accurately, and can also guide the intraoperative reduction precisely.
Citation：
XIANG Zhou, DUAN Xin, WANG Hong. Three-axis displacement classification of pelvic fracture and its reduction principles. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(10): 1153-1160. doi: 10.7507/1002-1892.201612030
Copy
Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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Wong JM, Bucknill A. Fractures of the pelvic ring. Injury, 2017, 48(4): 795-802.
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Pohlemann T, Stengel D, Tosounidis G, et al. Survival trends and predictors of mortality in severe pelvic trauma: estimates from the German Pelvic Trauma Registry Initiative. Injury, 2011, 42(10): 997-1002.
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Balogh Z, King KL, Mackay P, et al. The epidemiology of pelvic ring fractures: a population-based study. J Trauma, 2007, 63(5): 1066-1073.
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Yoshihara H, Yoneoka D. Demographic epidemiology of unstable pelvic fracture in the United States from 2000 to 2009: trends and in-hospital mortality. J Trauma Acute Care Surg, 2014, 76(2): 380-385.
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陈惟昌, 陈志华, 赵天德, 等. 可视化人体的整体坐标系统. Ct 理论与应用研究, 2004, 13(1): 1-6.0.
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徐青镭, 倪卫明, 万年宇. 人体髋关节周围肌肉三维生物力学模型的建立与应用. 伤残医学杂志, 2003, 11(3): 13-14.0.
|
| 7. |
Zheng G. Assessing the accuracy factors in the determination of postoperative acetabular cup orientation using hybrid 2D-3D registration. J Digit Imaging, 2010, 23(6): 769-779.
|
| 8. |
Borhani M, Mcgregor AH, Bull AM. An alternative technical marker set for the pelvis is more repeatable than the standard pelvic marker set. Gait Posture, 2013, 38(4): 1032-1037.
|
| 9. |
高金华, 郭晓山, 梁清宇, 等. 基于 X 线片与 CT 的不稳定型骨盆骨折 3D 分型研究. 中华创伤骨科杂志, 2013, 15(11): 961-966.0.
|
| 10. |
石成弟, 胡炜, 余可和, 等. 不稳定型骨盆骨折三维空间移位的 X 线诊断方法及其在闭合复位术中的初步应用. 中华创伤杂志, 2013, 29(8): 717-722.0.
|
- 1. Wong JM, Bucknill A. Fractures of the pelvic ring. Injury, 2017, 48(4): 795-802.
- 2. Pohlemann T, Stengel D, Tosounidis G, et al. Survival trends and predictors of mortality in severe pelvic trauma: estimates from the German Pelvic Trauma Registry Initiative. Injury, 2011, 42(10): 997-1002.
- 3. Balogh Z, King KL, Mackay P, et al. The epidemiology of pelvic ring fractures: a population-based study. J Trauma, 2007, 63(5): 1066-1073.
- 4. Yoshihara H, Yoneoka D. Demographic epidemiology of unstable pelvic fracture in the United States from 2000 to 2009: trends and in-hospital mortality. J Trauma Acute Care Surg, 2014, 76(2): 380-385.
- 5. 陈惟昌, 陈志华, 赵天德, 等. 可视化人体的整体坐标系统. Ct 理论与应用研究, 2004, 13(1): 1-6.0.
- 6. 徐青镭, 倪卫明, 万年宇. 人体髋关节周围肌肉三维生物力学模型的建立与应用. 伤残医学杂志, 2003, 11(3): 13-14.0.
- 7. Zheng G. Assessing the accuracy factors in the determination of postoperative acetabular cup orientation using hybrid 2D-3D registration. J Digit Imaging, 2010, 23(6): 769-779.
- 8. Borhani M, Mcgregor AH, Bull AM. An alternative technical marker set for the pelvis is more repeatable than the standard pelvic marker set. Gait Posture, 2013, 38(4): 1032-1037.
- 9. 高金华, 郭晓山, 梁清宇, 等. 基于 X 线片与 CT 的不稳定型骨盆骨折 3D 分型研究. 中华创伤骨科杂志, 2013, 15(11): 961-966.0.
- 10. 石成弟, 胡炜, 余可和, 等. 不稳定型骨盆骨折三维空间移位的 X 线诊断方法及其在闭合复位术中的初步应用. 中华创伤杂志, 2013, 29(8): 717-722.0.
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