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Abstract
Purpose
To acquire anatomical data for the normal pelvic bone structure using three-dimensional computed tomography (3D CT) and to propose the most appropriate angle and screw length for safe screw insertion during symphysis pubis plating.
Materials and Methods
We performed 3D CT analysis in 52 patients who required plating and selected a medial and lateral insertion point between the symphysis pubis and the pubic tubercle. Using a three-dimensional medical image analysis program, we evaluated the appropriate screw length, sagittal angle, and oblique angle at each point in this cohort.
Results
At the medial point, the sagittal angle was determined to be 49.1° with an average screw length of 49.4 mm. At the lateral point, we calculated an average screw length of 49.1 mm, oblique angle of 23.2°, and sagittal angle of 45.7°. The screw length was longer in men than in women (4.6 mm and 7.3 mm, respectively) at the medial and lateral point.
Figures and Tables
Fig. 1
(A) Initial pelvis antero-posterior image of a 47-year-old male showing pelvic ring injury with sacroiliac joint fracture and dislocation and symphysis pubis diastasis.
(B) Postoperative radiograph demonstrating the protruded screw at left pubis.
Fig. 2
A schematic picture showing screw fixation of symphysis pubis. A mark (*) of indicates pubic tubercle. Medial insertion point is the bisecting point between pubic tubercle and symphysis pubis; and lateral insertion point is just lateral to pubic tubercle.
Fig. 3
With 3-dimensional reconstruction image, measuring sagittal angle length at the medial insertion.
Fig. 4
With 3-dimensional reconstruction image, measuring.
(A) Sagittal angle and length.
(B) Oblique angle at the lateral position.
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