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Abstract：
BACKGROUND: The psoas minor partially inserted to the superior pelvic brim. And the plate used to fix the acetabular fracture has always been positioned at the pelvic brim after reduction through the Stoppa approach. However, there are few studies depicting the clinical significance of the psoas minor. The purpose of this paper was to explore the relationship between the insertion of the psoas minor tendon at the pelvic brim (IPMTPB) and screw placement through the Stoppa approach.
METHODS: Fifteen cadavers were dissected for adequate exposure to IPMTPB in our study. However, not all specimens had a psoas minor. For the specimens with IPMTPB, the posterior and anterior edges were used as the first and second entry points, dividing the area from the sacroiliac joint to the pubic symphysis into three zones (d1, d2 and d3). The average proportion of each zone was obtained after measurement the three zones, to locate the two entry points for the specimens without a psoas minor. From the longitudinal Stoppa incision, the first wire was inserted horizontally, and the second wire was placed vertical to the bone surface. Fluoroscopy and computed tomography (CT) were conducted to examine the relationship between the wires and the acetabulum.
RESULTS: There was a psoas minor in sixteen hemipelvises (53.33%). After measurement and calculation, we determined that the average proportions of zones d1, d2, and d3 were 28.03%, 29.14%, and 42.83%, respectively. For all specimens, the wires were successfully inserted, and the trajectories of the wires were outside the hip joint cavity.
CONCLUSIONS: IPMTPB could be used as an anatomic landmark of safe zones for screw placement through the Stoppa approach. For cases without a psoas minor, the zones for extra-articular screw placement could be determined through the measurements in this paper.
METHODS: Fifteen cadavers were dissected for adequate exposure to IPMTPB in our study. However, not all specimens had a psoas minor. For the specimens with IPMTPB, the posterior and anterior edges were used as the first and second entry points, dividing the area from the sacroiliac joint to the pubic symphysis into three zones (d1, d2 and d3). The average proportion of each zone was obtained after measurement the three zones, to locate the two entry points for the specimens without a psoas minor. From the longitudinal Stoppa incision, the first wire was inserted horizontally, and the second wire was placed vertical to the bone surface. Fluoroscopy and computed tomography (CT) were conducted to examine the relationship between the wires and the acetabulum.
RESULTS: There was a psoas minor in sixteen hemipelvises (53.33%). After measurement and calculation, we determined that the average proportions of zones d1, d2, and d3 were 28.03%, 29.14%, and 42.83%, respectively. For all specimens, the wires were successfully inserted, and the trajectories of the wires were outside the hip joint cavity.
CONCLUSIONS: IPMTPB could be used as an anatomic landmark of safe zones for screw placement through the Stoppa approach. For cases without a psoas minor, the zones for extra-articular screw placement could be determined through the measurements in this paper.
摘要：
背景：小腰肌部分插入骨盆上边缘。通过Stoppa入路复位后，用于固定髋臼骨折的钢板一直位于骨盆边缘。然而,很少有研究描述腰大肌的临床意义。本文的目的是探讨通过Stoppa入路在骨盆边缘插入腰大肌小肌腱（IPMTPB）与螺钉放置之间的关系。
方法：在我们的研究中，解剖了15具尸体，以充分暴露于IPMTPB。然而,不是所有的标本都有腰大肌小调。对于具有IPMTPB的样品，后边缘和前边缘被用作第一和第二入口点，将骶髂关节至耻骨联合的区域划分为三个区域(d1、d2和d3)。测量三个区域后获得每个区域的平均比例，找到没有腰大肌小调的标本的两个入口点。从纵向Stoppa切口，第一线是水平插入的，第二根线垂直于骨表面放置。进行了透视和计算机断层扫描（CT）检查，以检查导线与髋臼之间的关系。
结果：在16个半骨盆中有腰大肌（53.33％）。经过测量和计算，我们确定d1、d2和d3区的平均比例为28.03%，29.14%,42.83%，分别。对于所有标本，电线已成功插入，钢丝的轨迹在髋关节腔外。
结论：IPMTPB可以用作通过Stoppa方法放置螺钉的安全区的解剖标志。对于没有腰大肌未成年人的情况，通过本文的测量可以确定关节外螺钉放置的区域。
方法：在我们的研究中，解剖了15具尸体，以充分暴露于IPMTPB。然而,不是所有的标本都有腰大肌小调。对于具有IPMTPB的样品，后边缘和前边缘被用作第一和第二入口点，将骶髂关节至耻骨联合的区域划分为三个区域(d1、d2和d3)。测量三个区域后获得每个区域的平均比例，找到没有腰大肌小调的标本的两个入口点。从纵向Stoppa切口，第一线是水平插入的，第二根线垂直于骨表面放置。进行了透视和计算机断层扫描（CT）检查，以检查导线与髋臼之间的关系。
结果：在16个半骨盆中有腰大肌（53.33％）。经过测量和计算，我们确定d1、d2和d3区的平均比例为28.03%，29.14%,42.83%，分别。对于所有标本，电线已成功插入，钢丝的轨迹在髋关节腔外。
结论：IPMTPB可以用作通过Stoppa方法放置螺钉的安全区的解剖标志。对于没有腰大肌未成年人的情况，通过本文的测量可以确定关节外螺钉放置的区域。
