Infra-Acetabular Screw Exited Between Ischial Tuberosity and Ischial Spine is more Suitable for Asian Population: A 3D Morphometric Study

Abstract Background Recently, the infra-acetabular screw was proposed for acetabular fractures as a part of a periacetabular fixation frame. Biomechanical studies showed that an additional infra-acetabular screw placement can enhance the fixation strength of acetabular fracture internal fixation. At present, the reported exit point of the infra-acetabular screw was all located at the ischial tuberosity. However, through great experience in placing the infra-acetabular screw, we realized that when the exit point was located between the ischial tuberosity and the ischial spine, the placement of a 3.5 mm infra-acetabular screw is easier in some patients. Methods This study used axial perspective based on 3D models to study the anatomical parameters of the two different infra-acetabular screw corridors. Placed the largest diameter virtual screw in the two different screw corridors. The data obtained in this study present the maximum diameters, length, directions, and distances between the entry point and the center of IPE. Results In 65.31% males and 40.54% females, a Screw I corridor with a diameter of at least 5 mm was found, while in Screw II it was 77.55% in males and 62.16% in females. Compared with screw I, the length of screw II is reduced, the angle with the coronal plane is significantly reduced, and the angle with the transverse plane is significantly increased.Conclusions For East Asians, changing the exit point of the infra-acetabular screw can increase the scope of use of the infra-acetabular screw, especially for females.

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Infra-acetabular screw exited between ischial tuberosity and ischial spine is more suitable for Asian population: A 3D Morphometric study

10.21203/rs.3.rs-35275/v3 ◽

2020 ◽

Author(s):

Fei Liu ◽

Xiaoreng Feng ◽

Yang Xiao ◽

Jie Xiang ◽

Keyu Chen ◽

...

Keyword(s):

Asian Population ◽

3D Models ◽

Ischial Tuberosity ◽

Fixation Strength ◽

Maximum Diameter ◽

Acetabular Fractures ◽

Morphometric Study ◽

Exit Point ◽

Ischial Spine ◽

Length Direction

Abstract Background Recently, the infra-acetabular screw has been proposed for use in treatment of acetabular fractures as a part of a periacetabular fixation frame. Biomechanical studies have shown that an additional infra-acetabular screw placement can enhance the fixation strength of acetabular fracture internal fixation. Currently, the reported exit point of the infra-acetabular screw has been located at the ischial tuberosity (Screw I). However, our significant experience in placement of the infra-acetabular screw has suggested that when the exit point is located between the ischial tuberosity and the ischial spine (Screw II), the placement of a 3.5 mm infra-acetabular screw may be easier for some patients. We conducted this study in order to determine the anatomical differences between the two different IACs. Methods The raw datasets were reconstructed into 3D models using the software MIMICS. Then, the models, in the STL format model, were imported into the software Geomagic Studio to delete the inner triangular patches. Additionally, the STL format image processed by Geomagic Studio was imported again into MIMICS. Finally, we used an axial perspective based on 3D models in order to study the anatomical parameters of the two infra-acetabular screw corridors with different exit points. Hence, we placed the largest diameter virtual screw in the two different screw corridors. The data obtained from this study presents the maximum diameter, length, direction, and distances between the entry point and center of IPE. Results In 65.31% males and 40.54% females, we found a screw I corridor with a diameter of at least 5 mm, while a screw II corridor was present in 77.55% in males and 62.16% in females. Compared to screw I, the length of screw II is reduced, the angle with the coronal plane is significantly reduced, and the angle with the transverse plane is significantly increased.Conclusions For East Asians, changing the exit point of the infra-acetabular screw can increase the scope of infra-acetabular screw use, especially for females.

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Infra-acetabular screw exited between ischial tuberosity and ischial spine is more suitable for Asian population: a 3D morphometric study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03802-4 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Fei Liu ◽

Xiaoreng Feng ◽

Yang Xiao ◽

Jie Xiang ◽

Keyu Chen ◽

...

Keyword(s):

Asian Population ◽

3D Models ◽

Ischial Tuberosity ◽

Fixation Strength ◽

Maximum Diameter ◽

Acetabular Fractures ◽

Morphometric Study ◽

Exit Point ◽

Ischial Spine ◽

Length Direction

Abstract Background Recently, the infra-acetabular screw has been proposed for use in treatment of acetabular fractures as a part of a periacetabular fixation frame. Biomechanical studies have shown that an additional infra-acetabular screw placement can enhance the fixation strength of acetabular fracture internal fixation. Currently, the reported exit point of the infra-acetabular screw has been located at the ischial tuberosity (Screw I). However, our significant experience in placement of the infra-acetabular screw has suggested that when the exit point is located between the ischial tuberosity and the ischial spine (Screw II), the placement of a 3.5 mm infra-acetabular screw may be easier for some patients. We conducted this study in order to determine the anatomical differences between the two different IACs. Methods The raw datasets were reconstructed into 3D models using the software MIMICS. Then, the models, in the STL format model, were imported into the software Geomagic Studio to delete the inner triangular patches. Additionally, the STL format image processed by Geomagic Studio was imported again into MIMICS. Finally, we used an axial perspective based on 3D models in order to study the anatomical parameters of the two infra-acetabular screw corridors with different exit points. Hence, we placed the largest diameter virtual screw in the two different screw corridors. The data obtained from this study presents the maximum diameter, length, direction, and distances between the entry point and center of IPE. Results In 65.31% males and 40.54% females, we found a screw I corridor with a diameter of at least 5 mm, while a screw II corridor was present in 77.55% in males and 62.16% in females. Compared to screw I, the length of screw II is reduced, the angle with the coronal plane is significantly reduced, and the angle with the transverse plane is significantly increased. Conclusions For East Asians, changing the exit point of the infra-acetabular screw can increase the scope of infra-acetabular screw use, especially for females.

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Infra-acetabular screw exited between ischial tuberosity and ischial spine is more suitable for Asian population: A 3D Morphometric study

10.21203/rs.3.rs-35275/v2 ◽

2020 ◽

Author(s):

Fei Liu ◽

Xiaoreng Feng ◽

Yang Xiao ◽

Jie Xiang ◽

Keyu Chen ◽

...

Keyword(s):

Asian Population ◽

3D Models ◽

Ischial Tuberosity ◽

Fixation Strength ◽

Maximum Diameter ◽

Acetabular Fractures ◽

Morphometric Study ◽

Exit Point ◽

Ischial Spine ◽

Length Direction

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Anatomical Comparative Study of the External Nasal Nerve in Caucasian and Asian: Application for Minimizing Nerve Damage in Rhinoplasty

Aesthetic Plastic Surgery ◽

10.1007/s00266-021-02556-1 ◽

2021 ◽

Author(s):

Yue Chen ◽

Catherine B. Carr

Keyword(s):

Nerve Injury ◽

Average Distance ◽

Asian Population ◽

Anatomical Structure ◽

Full Description ◽

Exit Point ◽

Level Of Evidence ◽

Patient’S Satisfaction ◽

Type Iv ◽

Significant Difference

Abstract Background The numbness of the nasal tip is the main symptom of the external nasal nerve injury, especially after rhinoplasty. This postoperative syndrome can reduce the patient’s satisfaction with the operation. Having a better understanding of the anatomical structure and intraoperative protection can effectively avoid nerve injury. At present, the anatomical research on this nerve is all from Asia. This study aims to fill the gap in the anatomical study of this nerve in Caucasians and provides comparative results with Asians. Material and Methods A total of 20 Caucasian cadavers were embalmed using the Thiel method. On dissection, after complete exposure of the external nasal nerves, the distance between the exit point of the external nasal nerve and the nasal midline was measured, and the morphology of the nerves was compared with the Asian data. The nerves were classified into types based on their branching pattern. Results The nerve plane was the same as the Asian record. The distance ranged from 5.08 to 11.94 mm (mean, 8.31 ± 1.85 mm). This distance has statistical significant difference compared with the Asian population (P < 0.01). The average distance is larger, and the distribution range of the exit point is wider. On classification, 35 of 40 cases had the same type results as those previously reported, with the primary types I, II and III. Five new varieties were found which are classified as subtypes of the primary types and a new type IV. Furthermore, the bifurcation position in two-thirds of the type II cases and variations is proximal to that seen in the Asian population. Conclusions The anatomical structure of the external nasal nerve in Caucasians and Asians has obvious differences. This nerve in Caucasians is more likely to be damaged during rhinoplasty than Asians. Except the primary types, the classification of the external nasal nerve also includes subtypes and type IV. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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MORPHOMETRIC STUDY OF ISOLATED DOGIEL TYPE II CELLS OF THE INTERMUSCULAR PLEXUS

Archiv Euromedica ◽

10.35630/2199-885x/2021/11/3/4 ◽

2021 ◽

Vol 11 (3) ◽

pp. 17-19

Author(s):

Ramilya Babaeva

Keyword(s):

Small Intestine ◽

3D Model ◽

Longitudinal Direction ◽

3D Models ◽

Morphometric Study ◽

Type Ii Cells ◽

Impregnation Method ◽

Type Ii ◽

Type Ii Cell ◽

Dogiel Type Ii

Aim of the study was to calculate the morphometric parameters of isolated Dogiel type II cells from the intermuscular plexus of the small intestine. Materials and methods: 3D models of the oval-shaped Dogiel type II cells from the intermuscular plexus of a rat (n = 1) were constructed and studied. Neurocytes were identified by the impregnation method on the frontal and horizontal sections of the wall of the small intestine. Results: The results showed that the total number of the nodes in the virtual model was 36534, and the mesh elements — 156595. The resulting 3D model of the cell and nucleus was reduced 900 times to obtain a threedimensional cell and nucleus with absolute dimensions, with a ratio of 1:1 to their true size. The volume of Dogiel type II cell was 2785.11 μm³, the volume of the nucleus was 647.7 μm³ and the volume of its perikaryon was 2785.11 μm³. Conclusion: Dogiel type II cells from the intermuscular plexus of the rat small intestine has an ovoid shaped threedimensional structure. These cells are flattened in transverse direction and elongated in longitudinal direction.

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Feasibility study of transfacet sacroiliac screw fixation based on Mimics

10.21203/rs.3.rs-42564/v2 ◽

2020 ◽

Author(s):

Yanping Din ◽

Qudong Yin ◽

Shuai Liu ◽

Dong Li ◽

Yongwei Wu ◽

...

Keyword(s):

Sagittal Plane ◽

Longitudinal Axis ◽

Fixation Method ◽

Exit Point ◽

Sacroiliac Screw ◽

Screw Channel ◽

Line Parallel ◽

Sacroiliac Screw Fixation ◽

Scan Data ◽

Anatomical Parameters

Abstract Background Sacroiliac screw (SIS) has become an effective internal fixation method for sacral fracture and sacroiliac joint dislocation. However, classic placement of SIS has some defects such as possibility of nerve injury with a learning curve and contraindications. An alternative to the classic placement of SIS is expected Objective To explore the feasibility of transfacet sacroiliac screw (TFSIS), so as to provide an alternative to the classic placement of SIS. Methods CT scan data of pelvis in 60 healthy adults including 30 males and 30 females with an average age of 45 years (range 20-70 years), were transferred into a PC. The anatomical parameters of screw channel of TFSIS were measured by simulating the placement of TFSIS by Mimics 16.0 software on the PC. Secondly, according to the anatomical parameters of each pelvis, 5.0 mm and 6.0 mm screws were used respectively to simulate the placement of TFSIS in 30 pelvises to observe the effect of placement. Results The length of screw channel was (10.84 ± 0.93) cm, the distance between the insertion point and the center of the superior facet of S1 was (1.14 ± 0.93) mm, the distance between the exit point and the upper -posterior border of acetabulum was (5.73 ± 2.57) mm, the anteversion angle between the central axis of the screw channel and the line parallel to the upper endplate of S1 was (53.96±3.94) °, the outward angle between the central axial of the screw channel and the longitudinal axis of the trunk was (47.4 7± 5.13)°, the safety angle in sagittal plane was (13.91 ± 2.92) °, the safety angle in coronal plane was (8.57 ± 1.63) °, the height was (11.91 ± 1.47) mm, and the width was (7.75 ± 0.89) mm. Within the channel for 5.0mm and 6.0mm screws accounted for 100%. Conclusions Placement of TFSIS with a diameter of 5.0-6.0 mm and a length of 90 mm is safe and feasible, which may be used as an alternative to the classic placement of SIS.

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MPFL SURGICAL SIMULATION WITH FEMORAL DRILL HOLE ALLOWING FOR ADJUSTABLE GRAFT TENSION

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00044 ◽

2019 ◽

Vol 7 (3_suppl) ◽

pp. 2325967119S0004

Author(s):

Cooper Shea ◽

Audrey Rustad ◽

Nicolas G. Anchustegui ◽

Stockton Troyer ◽

Aleksei Dingel ◽

...

Keyword(s):

Articular Cartilage ◽

Surgical Simulation ◽

Femoral Condyle ◽

Drill Hole ◽

3D Models ◽

Mpfl Reconstruction ◽

Exit Point ◽

Graft Tension ◽

Patella Fractures ◽

Drill Holes

Background: In skeletally immature patients, the MPFL femoral origin as near or below the physis in most age groups. Although MPFL reconstruction procedures that employ patella drill holes facilitate graft tension adjustment, recent research demonstrates significant risk of patella fractures if patella drill holes are utilized. For this reason, the use of patella drill holes may be best avoided, but this technical alteration makes graft tension fixation more challenging during MPFL reconstruction in the skeletally immature. The purpose of this study was to evaluate the feasibility of developing a physeal respecting femoral drill for the MPFL origin with surgical model simulation, which allows for graft tensioning during MPFL reconstruction. Methods: Pediatric cadaveric specimens (n=5) were dissected by a group of fellowship trained pediatric and/or sports orthopaedic surgeons, and these specimens were then subject to CT Scans for the creation of 3D models. Specimens, aged 7, 9, 10, 11 and 11 years, were used to develop surgical simulations. CT Scans were loaded into Osyrix, converted to appropriate file structure, and then 3D models were loaded into Blender (Stichting Blender Foundation, Buikslotermeerplein 161, 1025 ETAmsterdam, the Netherlands). These models were used to evaluate 3D models of the knee, with placement of medial femoral condyle drill holes starting at the MPFL femoral origin, and entering the joint just anterior to the PCL femoral origin. The anatomic goals of the surgical simulation include: 1. Place drill hole at the MPFL origin on the femur. 2 Enter the intercondylar notch region of the femur anterior to the PCL origin allowing for arthroscopic visualization. 3. avoiding the articular cartilage on the medial femoral condyle. 4. Avoid the femoral physis throughout the course of drilling from the femoral MPFL Origin point to the entry location into the intercondylar notch. In the specimens, a full length drill hole was placed with either a 4 or 5 mm drill hole. Results: All specimens were subject to the surgical modeling and simulated drill hole placement. In each case, a drill hole was successfully placed meeting all the goals of the simulation: 1. Starting Point at MPFL, 2. Exit point anterior the PCL origin, 3. Exit point posterior to the articular cartilage, and 4. Avoidance of direct physeal injury. Figures 1 and 2. Conclusion: Setting graft tension during MPFL reconstruction is one of the significant technical challenges during MPFL reconstruction, and appropriate graft position and tension may be the most critical elements of successful MPFL reconstruction. Historically, graft tension has been set on the patella, using drill holes for the MPFL attachment point on the patella, but this technique has been associated with patella fractures. In order to allow for adjustment of graft tension on the femoral side of the MPFL graft during surgical reconstruction, a surgical simulation was developed to confirm the anatomic appropriateness and safety of placement of femoral drill holes which allow for adjustment of graft tension. This surgical simulation model confirms that MPFL femoral origin anatomy can be reproduced with injury to the physis, the PCL, or the articular cartilage of the femoral condyle. This drill hole and graft can be visualized arthroscopically and allow for appropriate graft tensioning during the procedure. [Figure: see text][Figure: see text]

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Three-Dimensional Analysis of the Curvature of the Femoral Canal in 426 Chinese Femurs

BioMed Research International ◽

10.1155/2015/318391 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Xiu-Yun Su ◽

Zhe Zhao ◽

Jing-Xin Zhao ◽

Li-Cheng Zhang ◽

An-Hua Long ◽

...

Keyword(s):

Sagittal Plane ◽

Three Dimensional ◽

3D Models ◽

Medullary Canal ◽

Femoral Length ◽

3D Space ◽

Positive Correlations ◽

And Gender ◽

Banking Angle ◽

Anatomical Parameters

Purpose. The human femur has long been considered to have an anatomical anterior curvature in the sagittal plane. We established a new method to evaluate the femoral curvature in three-dimensional (3D) space and reveal its influencing factors in Chinese population. Methods. 3D models of 426 femurs and the medullary canal were constructed using Mimics software. We standardized the positions of all femurs using 3ds Max software. After measuring the anatomical parameters, including the radius of femoral curvature (RFC) and banking angle, of the femurs using the established femur-specific coordinate system, we analyzed and determined the relationships between the anatomical parameters of the femur and the general characteristics of the population. Results. Pearson’s correlation analyses showed that there were positive correlations between the RFC and height (r=0.339, p<0.001) and the femoral length and RFC (r=0.369, p<0.001) and a negative correlation between the femoral length and banking angle (r=-0.223, p<0.001). Stepwise linear regression analyses showed that the most relevant factors for the RFC and banking angle were the femoral length and gender, respectively. Conclusions. This study concluded that the banking angle of the femur was significantly larger in female than in male.

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New technique and strategy for posterior column, posterior wall, ischium, and quadrilateral plate fixation from the anterior approach for acetabular fractures

10.21203/rs.3.rs-16869/v1 ◽

2020 ◽

Author(s):

Kunihiro Asanuma ◽

Gaku Miyamura ◽

Yoshiaki Suzuki ◽

Haruhiko Satonaka ◽

Kakunoshin Yoshida ◽

...

Keyword(s):

Anterior Approach ◽

Plate Fixation ◽

Posterior Wall ◽

Ischial Tuberosity ◽

Posterior Column ◽

Joint Surface ◽

Acetabular Fractures ◽

Quadrilateral Plate ◽

Screw Length ◽

Considerable Problem

Abstract BackgroundAcetabular fractures are relatively common, but management of the ischial fragment is a considerable problem when determining whether to use only the anterior approach or to add the posterior approach for anterior column and posterior hemitransverse acetabular fractures, T-type fractures, and both column fractures. This study is the first to demonstrate how to screw or drill around the quadrilateral space, posterior column, posterior wall, and near the ischial tuberosity from the anterior approach by a novel "sleeve guide technique". MethodsFirst, a nozzle, drill, depth gauge, and driver were prepared from DepuySynthes. Periosteum of the internal obturator muscle was detached from the quadrilateral plate to near the ischial tuberosity, while paying attention not to injure Alcock’s canal. The skin was cut about 1.5 cm opposite to the side of the fracture, and the nozzle was inserted as an external sleeve. Drilling, measuring screw length, and screwing were performed through this nozzle. With this technique, the approach angles of drilling and screwing to the posterior wall and ischium were inclined, and plating from the ischium to the ilium could be performed from the anterior approach. ResultsTwo cases are presented. Case 1 was a 63-year-old man who had a left both column fracture with a free bone fragment of the joint surface. After plating a 14-hole plate from the pubis to the ilium, a bent 14-hole plate was placed at the quadrilateral space as a buttress, and a screw was inserted from the posterior wall to the ilium using sleeve guide technique. Case 2 was a 66-year-old man with a quadrilateral fracture. After a 13-hole plate was bent and placed at the quadrilateral space, screws were inserted to the ischium and posterior wall using sleeve guide technique ConclusionsSleeve guide technique is very easy, useful, and safe to drill and insert screws to the quadrilateral space, posterior wall, and near the ischial tuberosity from the anterior approach. This technique can be used for simple drilling and screwing of a small T buttress plate held by a ball spike at the quadrilateral space from the surgical window. We believe that these techniques lead to new strategies for acetabular fractures.

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