二维透视导航与三维透视导航在骨盆骨折手术中应用的模型研究  

Comparison of two-dimensional and three-dimensional fluoroscopy based navigation in fixation of models with pelvic fracture

作　　者：胡承方[1] 罗从风[1] 冯大明[1] 张巍[1] 朱奕[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,上海200233

出　　处：《临床骨科杂志》2011年第6期705-709,共5页Journal of Clinical Orthopaedics

摘　　要：目的在骨盆模型上比较二维透视导航与三维透视导航在骨盆骨折螺钉置入手术中的应用价值,为指导临床应用提供参考数据。方法在10个骨盆模型上分别采用二维透视导航与三维透视导航的手术方式对双侧耻骨支、坐骨支及骶髂关节置入空心钉,记录60次操作的相关数据。结果二维透视导航手术的平均用时为(45.2±4.6)min,其中设备注册时间(1.6±0.3)min,获取图像时间(8.9±1.0)min,置入螺钉时间(26.6±2.5)min。置入螺钉长度平均为(87.7±11.4)mm,螺钉进入关节腔1次。三维透视导航手术的平均用时为(54.8±3.0)min,其中设备注册时间(1.5±0.3)min,获取图像时间(13.1±1.8)min,置入螺钉时间(26.4±2.4)min。置入螺钉长度平均为(93.7±8.5)mm,没有螺钉进入关节腔。结论导航下行骨盆螺钉固定的手术方式可以提高手术精确度,降低术后并发症的产生。相对于二维透视导航手术,三维透视导航手术虽然延长了手术时间,但为手术提供了更多的帮助,可以在数分钟时间内重建出多平面的三维影像,能使手术医师在第一时间获得骨折复位和内固定的重要信息,特别在骨盆手术中,能为准确置入尽可能长的螺钉发挥重要作用。Objective To compare the 2D-fluoroscopy-based navigation technique with 3D technique in the treatment of pelvis fracture in order to supply more statistics and instructions for the future clinical work.Methods The screws were inserted in the bilateral pubic branch,ischial ramus and sacroiliac joint in 10 pelvis models and the related data were recorded.Results The mean time by 2D navigation was(45.2±4.6) min,which included calibration time:(1.6±0.3) min,images receipt time:(8.9±1.0) min,the screw insertion:(26.6±2.5) min.The mean length of the screw was(87.7±11.4) mm.The screw penetrated the articulation once.The mean time by 3D navigation was(54.8±3.0) min,which included calibration time:(1.5±0.3) min,images receipt time:(13.1±1.8) min,the screw insertion:(26.4±2.4) min.The mean length of the screw was(93.7±8.5) mm.The screw didn′t penetrate the articulation yet.Conclusions Navigation is currently an effective method for operatively treated pelvis fractures.It is a new way to treat the pelvis fracture minimal invasively and fix the fragment accurately under the complex anatomy of the pelvic.Compared to the 2D-fluoroscopy-based navigation,3D technique provides more advantages to the operation such as the construction of multi-plane images in a short time which give the surgeon more information about the fracture reduction and fragment fixation.Moreover,the 3D technique plays an important role in inserting the long screws accurately in the treatment of pelvis fracture.

关 键 词：骨盆骨折 骨折固定术 二维透视导航 三维透视导航 

分 类 号：R68[医药卫生—骨科学]