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激光定位导航系统用于辅助股骨颈骨折空心螺钉置入术的实验研究
吴江红1,2,杨桓3,牛升波3,周潘宇1,赵玉婵1,4,许硕贵1,2*
0
(1. 海军军医大学(第二军医大学)第一附属医院创伤骨科,上海 200433;
2. 海军军医大学(第二军医大学)第一附属医院急诊科,上海 200433;
3. 海军军医大学(第二军医大学)第一附属医院脊柱外科,上海 200433;
4. 上海理工大学健康科学与工程学院,上海 200093
*通信作者)
摘要:
目的 观察一种新型的激光定位导航系统在辅助股骨颈骨折空心螺钉置入时能否减少导针穿刺次数、术中透视次数及提高置钉的准确性。方法 将20个由3D打印皮肤与人造股骨模型制成的大腿模型平均分配至传统C臂X线机透视引导组(传统组)和激光定位导航辅助组(导航组),每组10个。所有模型均按“平行、倒三角”的构型置入3枚导针。对两组的导针穿刺次数、术中透视次数及术后导针的平行度、分散度等进行统计学评价。结果 两组手术过程均顺利,60枚导针均成功置入,未穿出股骨颈皮质。导航组导针穿刺次数和术中透视次数均少于传统组[(5.3±1.8)次vs(7.5±2.3)次,P=0.03;(10.8±2.7)次vs(18.5±2.7)次,P<0.01]。导航组与对照组导针的平行度和分散度差异均无统计学意义(P均>0.05)。结论 新型激光定位导航系统能减少股骨颈骨折闭合复位空心螺钉内固定术中导针穿刺次数和术中透视次数,但对导针的平行度和分散度无明显改善。
关键词:  手术导航系统  股骨颈骨折  空心螺钉  微创手术
DOI:10.16781/j.CN31-2187/R.20210812
投稿时间:2021-08-17修订日期:2021-10-26
基金项目:军队后勤应急科研重点项目(BHJ20C008),军队应用基础研究重点项目(BLB18J006),上海市青年科技英才扬帆计划(21YF1458900),上海市科学技术委员会项目(19441901500)
Laser positioning and navigation system in assisting cannulated screw placement for femoral neck fracture: an experimental study
WU Jiang-hong1,2,YANG Huan3,NIU Sheng-bo3,ZHOU Pan-yu1,ZHAO Yu-chan1,4,XU Shuo-gui1,2*
(1. Department of Orthopaedics Trauma, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Department of Emergency, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
3. Department of Spinal Surgery, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
4. School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
*Corresponding author)
Abstract:
ObjectiveTo observe whether a new laser positioning and navigation system can reduce the total drilling attempts and the use of intraoperative fluoroscopy and improve the accuracy of guide pins when assisting cannulated screw placement in the femoral neck fractures.MethodsTwenty thigh models made using 3-dimensional printed skin and artificial femur models were equally divided into traditional C-arm X-ray fluoroscopic guidance group (traditional group) and laser positioning and navigation assistance group (navigation group), with 10 thigh models in each group. All models were placed with 3 guide pins in a "parallel and inverted triangle" configuration. The number of drilling attempts, the use of intraoperative fluoroscopy, and the parallelism and dispersion of guide pins were statistically evaluated after operation in the 2 groups.ResultsThe surgical procedures were uneventful in both groups, and all 60 guide pins were successfully placed without penetrating the femoral neck cortex. The numbers of drilling attempts and the use of intraoperative fluoroscopy in the navigation group were less than those in the traditional group (5.3±1.8 vs 7.5±2.3, P=0.03; 10.8±2.7 vs 18.5±2.7, P < 0.01). There were no significant differences in the parallelism or dispersion of the guide pins between the navigation group and the control group (both P > 0.05).ConclusionThis new laser positioning and navigation system can reduce the drilling attempts and the use of intraoperative fluoroscopy, but cannot improve the parallelism or dispersion of guide pins.
Key words:  surgical navigation system  femoral neck fracture  cannulated screw  minimally invasive surgery