X线透视导航在股骨转子间骨折髓内固定中的应用  

Intramedullary fixation of trochanteric fractures with fluoro-navigation

作　　者：邓宁[1] 吕红斌 范红斌 

机构地区：[1]香港特别行政区香港中文大学矫形外科及创伤学系

出　　处：《中华创伤骨科杂志》2005年第7期646-648,共3页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探索在X线透视导航下使用Gamma钉治疗股骨转子间骨折的方法。同时,对依据导航特性设计的新型Gamma-3和以往使用的Gamma-AP内固定系统进行比较。方法66例股骨转子间骨折患者在导航下行Gamma钉植入(40例使用Gamma-AP,26例使用Gamma-3),由同一观察者记录各种术中数据。结果Gamma-3治疗组较Gamma-AP组手术时间短(平均32min),切口小(平均5cm),操作中X线照射时间短(7min),且拉力螺钉位置好(顶轴距17.9mm)。结论使用导航系统微创置入Gamma钉不仅进针方向精确,拉力螺钉位置好,切口小,而且还可以减少术者的X线暴露时间。由于Gamma-3依据导航特性设计,其效果优于Gamma-AP系统。Objective To illustrate the application of fluoronavigation in Gamma nailing—a common surgical procedure in treatment of intertrochanteric fracture of femur and to compare the newly designed Gamma-3 system for navigation with the Gamma-AP system. Methods 66 patients with intertrochanteric fractures underwent Gamma nailing (40 Gamma-AP and 26 Gamma-3) under fluoronavigation guidance. An observer recorded the different intra-operative parameters. Results The Gamma-3 group showed superior results of shorter operation time (averaging 32 minutes), smaller surgical wound size (5cm), less X-ray requirement during procedure (7 times) and at the same time better lag screw position (Tip-Apex-Distance 17.9 mm). Conclusions Fluoronavigation can facilitate gamma nailing as a minimally invasive surgery because of its accurate guidance to nail insertion and lag screw positioning, a smaller surgical wound and minimized X-ray exposure suffered by operation theater staff. The Gamma-3 system has shown better results than the Gamma-AP system because of its navigation-specific design.

关 键 词：X线透视导航 GAMMA钉 顶轴距 股骨转子间骨折 

分 类 号：R687.3[医药卫生—骨科学]