研究者詳細 - 依光　正則

論文 - 依光　正則

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Study of the ideal insertion point and angle for the antegrade posterior column screw with the anterior approach in acetabular fracture. 国際誌

Shiro Fukuoka, Masanori Yorimitsu, Tomoyuki Noda, Toshifumi Ozaki

Injury 112575 - 112575 2025年7月

記述言語：英語

BACKGROUND: For acetabular fractures of both columns, the antegrade posterior column screw (APCS) is often inserted via the anterior intrapelvic approach to stabilize both columns. Insertion of the APCS can be technically demanding due to the complex anatomy of the posterior column. Misdirection or mispositioning of the screw during surgery can result in penetrate the hip joint or damage the neurovascular structures. The purpose of this study was to detect the ideal insertion point and angles of the APCS based on anatomical landmarks that can be directly identified intraoperatively. METHODS: We retrospectively reviewed the pelvic CT of 50 adults who underwent serial slice CT imaging. Three reference plane was determined using image analysis software; (1) iliac plane (IP), which contains the anterior superior iliac spine (ASIS), the anterior margin of sacroiliac joint (AMS), and the posterior margin of pubic symphysis (PMS), (2) pelvic inlet plane (PIP), which contains the AMS of both sides, and the PMS, (3) sagittal midline plane of the pelvis (SMP). The ideal insertion point and angles of the APCS, and its maximum length were measured. The ideal insertion point was measured on the line connecting ASIS and AMS (AA line) at a distance from AMS (APCS horizontal distance) and vertical distance from AA line (APCS vertical distance). The ideal angles were measured between the screw and the PIP and between the screw and the SMP. RESULTS: The APCS horizontal distance was 27.4 ± 6.4 mm. The APCS vertical distance was 1.6 ± 6.6 mm. The angle between the ideal APCS and yz-plane on the outlet view (α-angle) was 5.8 ± 5.8° The angle between the ideal APCS and y-axis on the xy-plane (β-angle) was 51.6 ± 5.0° The length of the APCS was 125.8 ± 9.5 mm. CONCLUSION: The ideal insertion point detected as the distance from the AMS on the AA line and the ideal insertion angles relative to the PIP and the SMP may aid in proper insertion of the APCS during surgery.

DOI： 10.1016/j.injury.2025.112575

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脛骨高原骨折の治療戦略脛骨近位端骨折に対するプレート固定単顆骨折および両顆骨折に対する使用の基本と応用

依光正則, 望月雄介, 長谷川翼, 奥田龍一郎, 安藤輝彦, 尾崎敏文

中部日本整形外科災害外科学会雑誌 68 ( 秋季学会 ) 59 - 59 2024年10月

寛骨臼骨折術後における臨床成績と予後因子の検討

福岡史朗, 依光正則, 志水紀之, 浪花崇一, 野田知之, 尾崎敏文

骨折 46 ( Suppl. ) S239 - S239 2024年6月

寛骨臼骨折術後における臨床成績と予後因子の検討

福岡史朗, 依光正則, 志水紀之, 浪花崇一, 野田知之, 尾崎敏文

骨折 46 ( Suppl. ) S239 - S239 2024年6月

脆弱性骨盤骨折の治療成績

中村大, 依光正則, 上原健敬, 福岡史朗, 奥田龍一郎, 佐々木和浩, 花川志郎, 尾崎敏文

骨折 46 ( Suppl. ) S247 - S247 2024年6月

大腿骨転子下骨折の順行性髄内釘術後回旋変形に関する多施設共同研究

奥田龍一郎, 依光正則, 福岡史朗, 山田和希, 上原健敬, 山川泰明, 鉄永智紀, 松本俊之, 尾崎敏文

骨折 46 ( Suppl. ) S135 - S135 2024年6月

Angiosomeを考慮した下肢手術のアプローチ法-骨折を中心に- Angiosomeを考慮した膝関節周囲外傷に対するアプローチ法

依光正則, 上原健敬, 志水紀之, 浪花崇一, 福岡史郎, 尾崎敏文

日本整形外科学会雑誌 98 ( 2 ) S144 - S144 2024年3月

脛骨骨折に対する異なるアプローチ間での髄内釘の挿入位置の検討

福岡史朗, 依光正則, 浪花崇一, 上原健敬, 尾崎敏文, 寺田忠司

骨折 46 ( 2 ) 503 - 505 2024年3月

3DCTを用いた載距突起への至適なscrew設置の解剖学的ランドマークの検討

福岡史朗, 依光正則, 志水紀之, 浪花崇一, 上原健敬, 尾崎敏文

骨折 46 ( 2 ) 520 - 523 2024年3月

Ideal insertion point and projection of the infra-acetabular screw in acetabular fracture surgery. 国際誌

Shiro Fukuoka, Masanori Yorimitsu, Takenori Uehara, Shuichi Naniwa, Toshiaki Hata, Kohei Sato, Tomoyuki Noda, Toru Sato, Toshifumi Ozaki

Injury 111264 - 111264 2023年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: In acetabular fracture surgery, an infra-acetabular screw (IAS) is inserted from the anterior to the posterior column through the infra-acetabular corridor to stabilize both columns. Although the IAS is useful for increasing fixation strength, proper placement requires proficiency and often results in extraosseous screw penetration. The complex anatomy of the infra-acetabular corridor and difficult intraoperative detection of the ideal insertion point and angle make proper placement of the IAS challenging. This study aimed to detect the ideal insertion point and angle of the IAS based on anatomical landmarks that can be directly identified intraoperatively. METHODS: We retrospectively reviewed the pelvic CT of 50 adults who underwent serial slice CT imaging. The pelvic inlet plane (PIP), which contains the anterior border of both the sacroiliac joint and posterior superior edge of the pubic symphysis, was used as the reference plane for the pelvic coordinate system to simulate the ideal insertion of IAS. The distance from the posterior superior edge of the pubic symphysis to the ideal insertion point of the IAS (IAS distance) and the angle and length of the IAS that could be inserted from the ideal insertion point were measured. RESULTS: The mean IAS distance was 61.0 ± 5.7 mm (57.6 ± 4.3 mm in men and 64.4 ± 4.9 mm in women). The mean angle between ideal IAS and yz-plane on the outlet view (α-angle) was 8.4 ± 6.6 ° (6.4 ± 5.6° in men and 10.5 ± 7.0° in women). The mean angle between ideal IAS and y-axis on the yz-plane (β-angle) was 86.5 ± 10.6 ° (86.0 ± 10.3° in men and 87.0 ± 10.9° in women). The length of IAS was 97.1 ± 4.7 mm in men and 89.2 ± 3.6 mm in women. CONCLUSION: The IAS ideal insertion point detected as a distance from the pubic symphysis may aid in the proper insertion of the IAS during surgery. The insertion angle was parallel or tilted 10 ° laterally to the longitudinal axis in the pelvic outlet plane and almost perpendicular to the PIP in the sagittal plane when inserted from the ideal insertion point.

DOI： 10.1016/j.injury.2023.111264

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みんなで行う骨転移診療-診療均てん化を目指した整形外科キャリアステージ別スキルの再確認- 骨転移診療のスキル外傷整形外科医編

野田知之, 阿部信寛, 尾崎敏文, 中田英二, 依光正則, 上原健敬

日本整形外科学会雑誌 97 ( 11 ) 993 - 997 2023年11月