ISO-C3D计算机辅助狄郊航技术经皮微创内固定治疗髋臼骨折.docVIP

ISO-C3D计算机辅助导航技术经皮微创内固定治疗髋臼骨折★ 马玉鹏，周东生，李连欣，穆卫东，何吉亮，李庆虎(山东大学附属省立医院创伤骨科，山东省济南市 250021) 文章亮点： 1 通过对ISO-C3D计算机辅助导航技术的临床应用分析了计算机导航系统治疗髋臼骨折的可行性与特点。 2 结果说明ISO-C3D计算机辅助导航技术内固定治疗髋臼骨折，具有创伤小、出血少、术中时间短、操作简便、置钉准确性高的特点，且并发症少。计算机辅助导航技术微创治疗髋臼骨折，通过逆行性拉力螺钉固定，固定牢固，使患者能够早期功能锻炼。内固定后患者功能恢复较好。 关键词： 骨关节植入物；数字化骨科；骨盆骨折；计算机辅助导航；经皮内固定；微创手术；髋臼骨折 主题词： 骨盆；髋臼；骨折；外科手术，计算机辅助；外科手术，微创性 摘要 背景：文献报道采用X射线透视下经皮空心螺钉治疗骨盆髋臼骨折，但其内固定时间长，且患者与医生的放射暴露量大。 目的：评价ISO-C3D计算机辅助导航微创技术在髋臼骨折治疗中的应用效果。 方法：采用计算机辅助导航下经皮微创内固定治疗骨盆髋臼骨折31例，患者伤后至内固定时间为4-13 d。所有患者随访满1年。 结果与结论：患者内固定治疗中除1例伴有骶髂关节损伤行切开复位内固定患者出血量约300 mL，其余患者平均出血量18 mL。内固定中共置入螺钉42枚，髋臼前柱骨折螺钉24枚，后柱螺钉18枚，所有螺钉均一次性准确置入。平均内固定时间59 min，平均透视时间为39 s。31例患者治疗后1周疼痛明显减轻，均无感染、血管神经损伤、内固定物断裂等并发症发生。至随访结束，摄X射线片示骨折愈合，无螺钉断裂及松动，根据Matta临床评分标准，优23例，良8例，优良率100%。内固定后髋关节功能根据Majeed 评分系统：优22例，良6例，可3例，优良率90%。提示ISO-C3D计算机辅助导航技术经皮微创内固定治疗可实现坚强内固定，且治疗中创伤小，内固定后并发症较少。 Minimally invasive percutaneous fixation based on ISO-C3D computerized navigational system for fracture of the acetabulum Ma Yu-peng, Zhou Dong-sheng, Li Lian-xin, Mu Wei-dong, He Ji-liang, Li Qing-hu (Department of Trauma Orthopedics, Shandong Provincial Hospital, Shandong University, Jinan 250021, Shandong Province, China) Abstract BACKGROUND: Percutaneous hollow screw under X-Ray fluoroscopy has been shown to treat fracture of acetabulum of the pelvis, but the time of internal fixation was long, and the amount of radiation exposure to the patients and physicians was large. OBJECTIVE: To test the application of the ISO-C3D computerized navigational system for fracture of acetabulum. METHODS: Thirty-one patients with fracture of the acetabulum were treated with percutaneous hollow screw under a fluoroscopy-based ISO-C3D computerized navigational system. The interval from injury to operation was 4 to 13 days. All patients were followed up for one year. RESULTS AND CONCLUSION: The average bleeding volume during operation was only 18 mL, except that the bleeding volume of only one patient, who suffered from the sacroiliacjoint injury and