股骨颈内定位器的研制与初步应用  

Designing and preliminary application of a human femoral neck locator

作　　者：马台[1] 党瑞山[2] 丁任[1] 石关桐[1] 孙建忠[1] 徐进[1] 

机构地区：[1]上海中医药大学附属曙光医院宝山分院骨科,上海201900 [2]第二军医大学解剖学教研室,上海200433

出　　处：《解剖学杂志》2010年第5期681-683,共3页Chinese Journal of Anatomy

基　　金：上海市宝山区科委资助项目（06-E-06）

摘　　要：目的：研发一种适用于治疗股骨颈骨折时打入空心加压螺钉的定位器.方法：定位器由操作柄、定位齿、从动齿、衔接器和导向板等部件构成.应用时利用股骨颈Ward三角区骨小梁稀疏、类似＂髓腔＂的解剖特点,在股骨上端外侧开一骨窗,定位器头端经此骨窗伸入股骨颈的松质骨内,体外操作,使定位齿探触股骨颈内拟定置针位置,再经导向板的导引孔打入导针.在5具国人成人尸体10例股骨颈上进行模拟手术,每例股骨颈从上方、下方、后方骨皮质内面3个点位各置入1枚导针,验证其置钉的准确性.结果：以定位齿确定的点位（靶点）为坐标原点（0,0）、定位齿为Y轴正向建立坐标系,测得导针置入位置的坐标x、 y分别为（0.40±0.56）mm,（1.07±1.01）mm.未出现导针打到股骨颈外的现象.结论：本定位器结构简单、操作简便、定位准确.Objective： To design a new kind of locator for compression hollow screw, when treating femoral neck fracture. Methods： The locator was constituted by conductor handle, localization dens, following dens, adapter, deflector and so on. Ward＇s triangle femoral neck trabecular bone sparse, similar to bone marrow, were applied with these anatomical features. At intersection of the lateral femur and femoral neck axis of the bone cortex, a bone window was opened. We stretched the head of the locator into the cancellous bone of femoral neck through this bone window. Operation of the process was in vitro. Head positioning teeth could easily touch the top, bottom and rear side of the central cortical bone of the femoral neck. And then the pilot aimed the location the positioning teeth to infiltrate the guide pin accurately. In this study, five human fresh bodies （10 femoral neck specimens） were tested, and a guide pin was inserted in each femoral neck from the top, bottom and rear locations. Results：First use the site which was determined by localization dens as the origin of coordinate and Y-axis forward direction to set the coordinate system. And then measure the infiltrate position of the guide pin （0. 40±0.56 mm, 1.07±1.01 mm）. There was no phenomenon that the broken of the human femoral cortex to the neck outside the lead stylus. Conclusion： The structure of the locator is simple. And it is easy to operate and position accurately.

关 键 词：股骨颈骨折 定位 器械 设计 

分 类 号：R683.42[医药卫生—骨科学]