CN106580354A - Pelvis displacement measuring method based on pelvis plain film - Google Patents
Pelvis displacement measuring method based on pelvis plain film Download PDFInfo
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- CN106580354A CN106580354A CN201611114872.6A CN201611114872A CN106580354A CN 106580354 A CN106580354 A CN 106580354A CN 201611114872 A CN201611114872 A CN 201611114872A CN 106580354 A CN106580354 A CN 106580354A
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- 210000004197 pelvis Anatomy 0.000 title claims abstract description 49
- 238000006073 displacement reaction Methods 0.000 title claims abstract description 41
- 238000000034 method Methods 0.000 title claims abstract description 35
- 238000005259 measurement Methods 0.000 claims abstract description 21
- 230000003447 ipsilateral effect Effects 0.000 claims description 21
- 238000013519 translation Methods 0.000 claims description 8
- 238000007689 inspection Methods 0.000 claims description 3
- 210000000988 bone and bone Anatomy 0.000 claims description 2
- 210000003692 ilium Anatomy 0.000 claims 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims 1
- 230000009467 reduction Effects 0.000 abstract description 14
- 230000000740 bleeding effect Effects 0.000 abstract description 4
- 208000015181 infectious disease Diseases 0.000 abstract description 4
- 210000003131 sacroiliac joint Anatomy 0.000 abstract 1
- 230000014616 translation Effects 0.000 description 7
- 206010034246 Pelvic fractures Diseases 0.000 description 4
- 210000004369 blood Anatomy 0.000 description 3
- 239000008280 blood Substances 0.000 description 3
- 230000006378 damage Effects 0.000 description 3
- 230000008569 process Effects 0.000 description 3
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 238000002474 experimental method Methods 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 210000000056 organ Anatomy 0.000 description 2
- 230000005855 radiation Effects 0.000 description 2
- 208000035965 Postoperative Complications Diseases 0.000 description 1
- 238000012274 Preoperative evaluation Methods 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000005520 cutting process Methods 0.000 description 1
- 238000001514 detection method Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 210000003414 extremity Anatomy 0.000 description 1
- 230000001788 irregular Effects 0.000 description 1
- 210000003141 lower extremity Anatomy 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 230000000877 morphologic effect Effects 0.000 description 1
- 210000005036 nerve Anatomy 0.000 description 1
- 210000001696 pelvic girdle Anatomy 0.000 description 1
- 230000035479 physiological effects, processes and functions Effects 0.000 description 1
- 238000011946 reduction process Methods 0.000 description 1
- 238000012552 review Methods 0.000 description 1
- 230000035939 shock Effects 0.000 description 1
- 210000004872 soft tissue Anatomy 0.000 description 1
- 230000004083 survival effect Effects 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
- A61B6/505—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of bone
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Abstract
The invention discloses a pelvis displacement measuring method based on a pelvis plain film. The method comprises the following steps of Step 1, X ray examination; Step 2, measuring basis building; Step 3, measurement and calculation; and Step 4, measurement result expression, wherein on a front and back position plain film, the anterior superior iliac spine (A) and the ischial tuberosity (B) are selected to be used as mark points; on an inlet position flat sheet, the sacroiliac joint front side (H), the anterior superior spine (G) and the sacrum endplate center (S) are selected to be used as mark points; on an outlet position plain film, the crista iliaca highest point (C, the anterior superior iliac spine (E) and the tuber ischiadicum (D) are selected to be used as mark points. According to the method, the pelvis front and back position, inlet position and outlet position X ray films are sufficiently utilized; whether the pelvis displacement occurs or not and the concrete displacement conditions are systematically measured; the reset path of the pelvis closed reduction is planned in an auxiliary way; the reduction precision can be effectively improved; the operation time of the closed reduction and the perspective time are reduced; and the bleeding quantity and the infection risk of a patient can be further reduced.
Description
Technical field
The present invention relates to pelvis diagnostic measurement technical field, specially a kind of pelvis displacement measurement side based on AP roentgenograms
Method.
Background technology
Pelvis is transferred to close as the important feature for accepting backbone and lower limb, the integrality of its structure to Human Physiology mechanics
Important, the numerous important organs of pelvic ring inner containment and nervus vasculairs, once high violence occurs damaging, easily cause blood loss stopping
Gram and the severe complication such as limb function deformity.But the treatment of the pelvic fracture challenge high for orthopedist has.Although
Contemporary osteology is fast-developing, and pelvic fracture still has very high fatal rate and disability rate, in order at utmost reduce pelvis bone
The complication rate and survival rates of folding, accurate reset is then particularly important with timely fixation.Traditional therapeutic modality,
Open reduction and Kirschner wire fixation, though under direct-view anatomical reduction, cutting operation Massive Bleeding can be easy to undoubtedly to increase blood volume
It is not enough, accelerate shock process, the condition of the injury for making the sick and wounded originally critical makes the matter worse, and due to posterior ring pelvic position depth, perform the operation into
Road needs big otch and extensive soft tissue to peel off, important organ in pelvis, and blood vesssls and nerves injuries risk and infection rate all can be with
Increase, follow-up operative treatment is also very thorny.And closed reduction pelvic fracture adds minimally invasive screw technique to be then avoided that incision
Reset in caused above art or postoperative complications, be increasingly becoming the development trend and study hotspot of pelvic fracture treatment.So
And the preoperative evaluation of traditional closed reduction, experience being relied on reset path planning, while whole process is required to the x-ray in art more
Monitoring under carry out, excessive to the exposure of the ray of medical personnel, its reset result is also difficult to anatomical reduction.Because pelvis has
The 3 D anatomy structure of complexity, irregular spatial shape and various damage mechanisms and displacement situation, therefore corresponding measurement side
Method also must be able to accurately, comprehensively react its overall displacement situation and Morphological Characteristics.It is different by the past review of literature
Author's proposition is improved on the basis of forefathers, establishes the measuring method of various pelvises displacements, but can be extensive still without one kind
Acceptance, all there is absent standardized process in majority, the problems such as confidence level and stability difference, it is difficult to be applied to clinic well.
Therefore clinically in the urgent need to a kind of method, comprehensive and accurate pelvis displacement measurement can be carried out, and can determine whether whether pelvis moves
Position and situation is specifically shifted, and accurate reset path planning is further aided in, to instruct closed reduction process.
The content of the invention
It is an object of the invention to provide a kind of pelvis based on AP roentgenograms shifts measuring method, to solve above-mentioned background
The problem proposed in technology.
For achieving the above object, the present invention provides following technical scheme：
A kind of pelvis based on AP roentgenograms shifts measuring method, comprises the following steps：
S1：X-ray is checked：Human pelvis are carried out with x-ray inspection, including anteroposterior position, entrance position and outlet position；
S2：Set up measuring basis：Including coordinate system and index point, wherein：
Coordinate system：Set up on the basis of the AP roentgenograms of standard, by the entrance position of pelvis, outlet position plain film is defined as X/
Z, X/Y plane, by the pelvis lateral radiograph vertical with above-mentioned plane Y/Z planes are defined as；
Index point：On anteroposterior position plain film, anterior superior spine (A) and ischial tuberosity (B) are selected as index point；Entrance position plain film
On, articulatio sacroiliaca front (H), anterior superior spine (G) and rumpbone soleplate center (S) are selected as index point；On outlet position plain film, choosing
Crista iliaca peak (C), anterior superior spine (E) and ischial tuberosity (D) are selected for index point；And corresponding index point is used on specific plain film
Capitalization represents strong side mark point, adds after letter ' represent Ipsilateral mark point；
S3：Measure and calculate：The measurement and calculating in entrance position plain film, outlet position plain film and anteroposterior position plain film is included in,
Wherein：
On entrance position plain film (i.e. X/Z planes), calculate Ipsilateral articulatio sacroiliaca front (H ') and rumpbone soleplate center (S) and
The horizontal range difference and vertical range at strong side articulatio sacroiliaca front (H) and rumpbone soleplate center (S) is poor, compares with 0cm respectively.Meter
Strong side anterior superior spine (G) and articulatio sacroiliaca front (H) horizontal range are calculated with Ipsilateral anterior superior spine (G ') and articulatio sacroiliaca front
(H ') horizontal range is poor, and compares with 2cm.
In outlet position plain film (i.e. X/Y planes), calculate Ipsilateral crista iliaca peak (C ') and rumpbone soleplate center (S) and be good for
The vertical range at side crista iliaca peak (C) and rumpbone soleplate center (S) is poor, and compares with 0cm.Calculate strong side anterior superior spine (E)
It is poor with Ipsilateral anterior superior spine (E ') and ischial tuberosity (D ') horizontal range with ischial tuberosity (D) horizontal range, and compare with 2cm.
On anteroposterior position plain film, strong side anterior superior spine (A) and ischial tuberosity (B) horizontal range and Ipsilateral anterior superior spine are calculated
(A ') and ischial tuberosity (B ') horizontal range are poor, and compare with 2cm.
S4：Measurement result is represented：
Measurement result is represented using following expression：
Wherein, R/L represents Ipsilateral as left side or right side, and I, O, A represent respectively the entrance position of pelvis, export position, in front and back
Position plain film, X, Y, Z represent respectively the translation displacement situation on respective axle, and R represents the rotation displacement situation in respective plane,
None represent do not shift, translation displacement when ,+represent to positive axis displacement ,-represent to negative axle displacement, during rotation displacement ,+represent it is suitable
Hour hands are shifted ,-represent displaced counter-clockwise.
Compared with prior art, the invention has the beneficial effects as follows：
1st, compared with existing measuring method, this method has standardized measurement procedure, the coordinate system of strict regulations, mark
Point, measure equation and expression formula, control the skew that subjective experience is caused, and make the stability and confidence level of measurement result higher；
2nd, make full use of entrance position, export position, three X-ray films of anteroposterior position describe pelvis on three orthogonal planes
All translation and rotation displacement, comprehensively reflect whether pelvis shifts and displacement situation, make measurement more complete, it is to avoid lose
Leakage；
3rd, compared to CT examination, this method have save patient spend, reduce patient radiation's line exposed amount the advantages of；
4th, during traditional closed reduction, the displacement of patient's micro-judgment pelvis is relied primarily on, by contrast, this method can be more
Plus objective comprehensively judge that pelvis shifts situation, repeatable high, good stability.Preoperative use this method auxiliary reset path
Planning, can increase the accuracy of closed reduction, reduce operating time and the perspective time of closed reduction, and further reduce patient
Amount of bleeding and infection risk.Confirmed by experiment and clinical observation, the pelvis displacement measuring method has good stablizing
Property, it is to judge that pelvis shifts situation, instructs the reliable method of closed reduction.
Description of the drawings
Fig. 1 is the pelvis coordinate system that patent of the present invention is set up；
Fig. 2 is that entrance position plain film index point position is illustrated；
Fig. 3 is that outlet position plain film index point position is illustrated；
Fig. 4 is that anteroposterior position plain film index point position is illustrated.
In figure：G is anterior superior spine, central point, the E that H is articulatio sacroiliaca front, S is rumpbone soleplate in the plain film of entrance position
For export position with the anterior superior spine in piece, C be crista iliaca peak, D be ischial tuberosity, S be the central point of rumpbone soleplate, A be front
Anterior superior spine afterwards in the plain film of position, B are ischial tuberosity.
Specific embodiment
Below in conjunction with the accompanying drawing in the embodiment of the present invention, the technical scheme in the embodiment of the present invention is carried out clear, complete
Site preparation is described, it is clear that described embodiment is only a part of embodiment of the invention, rather than the embodiment of whole.It is based on
Embodiment in the present invention, it is every other that those of ordinary skill in the art are obtained under the premise of creative work is not made
Embodiment, belongs to the scope of protection of the invention.
Fig. 1-4 are referred to, the present invention provides a kind of pelvis based on AP roentgenograms and shifts measuring method, including following step
Suddenly：
S1：X-ray is checked：Human pelvis are carried out with x-ray inspection, including anteroposterior position, entrance position and outlet position；
S2：Set up measuring basis：Including coordinate system and index point, wherein：
Coordinate system：Set up on the basis of the AP roentgenograms of standard, by the entrance position of pelvis, outlet position plain film is defined as X/
Z, X/Y plane, by the pelvis lateral radiograph vertical with above-mentioned plane Y/Z planes are defined as；
Index point：On anteroposterior position plain film, anterior superior spine (A) and ischial tuberosity (B) are selected as index point；Entrance position plain film
On, articulatio sacroiliaca front (H), anterior superior spine (G) and rumpbone soleplate center (S) are selected as index point；On outlet position plain film, choosing
Crista iliaca peak (C), anterior superior spine (E) and ischial tuberosity (D) are selected for index point；And corresponding index point is used on specific plain film
Capitalization represents strong side mark point, adds after letter ' Ipsilateral mark point is represented, mark point and its representation see the table below：
Index point and representation on the AP roentgenograms of table 1
S3：Measure and calculate：The measurement and calculating in entrance position plain film, outlet position plain film and anteroposterior position plain film is included in,
Wherein：
On entrance position plain film (i.e. X/Z planes), calculate Ipsilateral articulatio sacroiliaca front (H ') and rumpbone soleplate center (S) and
The horizontal range difference and vertical range at strong side articulatio sacroiliaca front (H) and rumpbone soleplate center (S) is poor, compares with 0cm respectively.Meter
Strong side anterior superior spine (G) and articulatio sacroiliaca front (H) horizontal range are calculated with Ipsilateral anterior superior spine (G ') and articulatio sacroiliaca front
(H ') horizontal range is poor, and compares with 2cm.
In outlet position plain film (i.e. X/Y planes), calculate Ipsilateral crista iliaca peak (C ') and rumpbone soleplate center (S) and be good for
The vertical range at side crista iliaca peak (C) and rumpbone soleplate center (S) is poor, and compares with 0cm.Calculate strong side anterior superior spine (E)
It is poor with Ipsilateral anterior superior spine (E ') and ischial tuberosity (D ') horizontal range with ischial tuberosity (D) horizontal range, and compare with 2cm.
On anteroposterior position plain film, strong side anterior superior spine (A) and ischial tuberosity (B) horizontal range and Ipsilateral anterior superior spine are calculated
(A ') and ischial tuberosity (B ') horizontal range are poor, and compare with 2cm.
The measure equation in table 2 is make use of in measurement, specially the displacement of pelvis is decomposed on tri- axles of X/Y/Z
2 kinds of forms of motion (translation and rotate), altogether 6 kinds of basic displacement modes.The displacement of pelvis is believed that this 6 kinds of basic displacement modes
Permutation and combination.The calculating of pelvis displacement formula is by measuring horizontal range and vertical range between anatomic landmark, and and constant
Relatively draw.X represents the distance in plain film on trunnion axis in formula, and Y represents the distance in plain film on vertical axis；
The pelvis displacement formula of table 2
S4：Measurement result is represented：
Measurement result is represented using following expression：
Wherein, R/L represents Ipsilateral as left side or right side, and I, O, A represent respectively the entrance position of pelvis, export position, in front and back
Position plain film, X, Y, Z represent respectively the translation displacement situation on respective axle, and R represents the rotation displacement situation in respective plane,
None represent do not shift, translation displacement when ,+represent to positive axis displacement ,-represent to negative axle displacement, during rotation displacement ,+represent it is suitable
Hour hands are shifted ,-represent displaced counter-clockwise.
Compared with existing measuring method, this method has standardized measurement procedure to the measuring method that the present invention is adopted, sternly
The coordinate system that lattice specify, index point, measure equation and expression formula, control the skew that subjective experience is caused, and make measurement result
Stability and confidence level are higher.
The measuring method that the present invention is adopted makes full use of entrance position, exports position, and three X-ray films of anteroposterior position describe pelvis
Whole translations and rotation displacement on three orthogonal planes, comprehensively reflect whether pelvis shifts and displacement situation, make survey
Amount is more complete, it is to avoid omit；Compared to CT examination, this method has saves patient's cost, reduces patient radiation's line exposed amount
The advantages of；
The measuring method that the present invention is adopted more objective can comprehensively judge that pelvis shifts situation, eliminate the reliance on traditional Jing
The detection of judgement formula is tested, repeatable high, good stability；The planning in preoperative use this method auxiliary reset path, can increase closure
The accuracy of reset, reduces operating time and the perspective time of closed reduction, and further reduces amount of bleeding and the infection of patient
Risk.Confirmed by experiment and clinical observation, the pelvis displacement measuring method has good stability, be to judge that pelvis is moved
Position situation, instructs the reliable method of closed reduction.
Although an embodiment of the present invention has been shown and described, for the ordinary skill in the art, can be with
Understanding can carry out various changes, modification, replacement to these embodiments without departing from the principles and spirit of the present invention
And modification, the scope of the present invention be defined by the appended.
Claims (1)
1. a kind of pelvis based on AP roentgenograms shifts measuring method, it is characterised in that comprise the following steps：
S1：X-ray is checked：Human pelvis are carried out with x-ray inspection, including anteroposterior position, entrance position and outlet position；
S2：Set up measuring basis：Including coordinate system and index point, wherein：
Coordinate system：Set up on the basis of the AP roentgenograms of standard, by the entrance position of pelvis, outlet position plain film is defined as X/Z, X/
Y plane, by the pelvis lateral radiograph vertical with above-mentioned plane Y/Z planes are defined as；
Index point：On anteroposterior position plain film, anterior superior spine (A) and ischial tuberosity (B) are selected as index point；On the plain film of entrance position,
Articulatio sacroiliaca front (H), anterior superior spine (G) and rumpbone soleplate center (S) are selected as index point；On outlet position plain film, select
Crista iliaca peak (C), anterior superior spine (E) and ischial tuberosity (D) are index point；And corresponding index point is on specific plain film with greatly
Lowercase alphabet shows strong side mark point, adds after letter ' represent Ipsilateral mark point；
S3：Measure and calculate：The measurement and calculating of entrance position plain film, outlet position plain film and anteroposterior position plain film are included in, wherein：
On entrance position plain film (i.e. X/Z planes), Ipsilateral articulatio sacroiliaca front (H ') and rumpbone soleplate center (S) and strong side are calculated
The horizontal range difference at articulatio sacroiliaca front (H) and rumpbone soleplate center (S) and vertical range are poor, compare with 0cm respectively.Calculate strong
Side anterior superior spine (G) and articulatio sacroiliaca front (H) horizontal range and Ipsilateral anterior superior spine (G ') and articulatio sacroiliaca front (H ') water
Flat range difference, and compare with 2cm.
In outlet position plain film (i.e. X/Y planes), Ipsilateral crista iliaca peak (C ') and rumpbone soleplate center (S) and strong side ilium are calculated
The vertical range at ridge peak (C) and rumpbone soleplate center (S) is poor, and compares with 0cm.Calculate strong side anterior superior spine (E) and sit
Bone tubercle (D) horizontal range is poor with Ipsilateral anterior superior spine (E ') and ischial tuberosity (D ') horizontal range, and compares with 2cm.
On anteroposterior position plain film, strong side anterior superior spine (A) and ischial tuberosity (B) horizontal range and Ipsilateral anterior superior spine (A ') are calculated
It is poor with ischial tuberosity (B ') horizontal range, and compare with 2cm.
S4：Measurement result is represented：
Measurement result is represented using following expression：
Wherein, R/L represents Ipsilateral as left side or right side, and I, O, A represent respectively the entrance position of pelvis, export position, and anteroposterior position is put down
Piece, X, Y, Z represent respectively the translation displacement situation on respective axle, and R represents the rotation displacement situation in respective plane, none
Representative is not shifted, when translating displacement ,+represent to positive axis displacement ,-represent to the displacement of negative axle, during rotation displacement ,+represent clockwise
Displacement ,-represent displaced counter-clockwise.
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108283561A (en) * | 2018-01-29 | 2018-07-17 | 北京大学深圳医院（北京大学深圳临床医学院） | Real-time monitoring device and method for the displacement of hip replacement midpelvis |
| CN114554954A (en) * | 2019-10-16 | 2022-05-27 | 桑拉斯控股有限公司 | Method for determining the position and orientation of a pelvic bone of a person |
-
2016
- 2016-12-07 CN CN201611114872.6A patent/CN106580354A/en active Pending
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108283561A (en) * | 2018-01-29 | 2018-07-17 | 北京大学深圳医院（北京大学深圳临床医学院） | Real-time monitoring device and method for the displacement of hip replacement midpelvis |
| CN114554954A (en) * | 2019-10-16 | 2022-05-27 | 桑拉斯控股有限公司 | Method for determining the position and orientation of a pelvic bone of a person |
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Application publication date: 20170426 |