Sureshot远端瞄准系统进行股骨髓内钉远端锁钉操作的临床应用价值分析  

Analysis on clinical application value of Sureshot Distal Targeting System in locking intrameduallary nail for femoral shaft fracture

作　　者：王臣[1] 肖万军[1] WANG Chen X(Department of Orthopaedics, the Fourth People＇s Hospital of Shenyang, Shenyang 110031, China)

机构地区：[1]沈阳市第四人民医院骨外科,沈阳110031

出　　处：《创伤外科杂志》2017年第8期578-582,共5页Journal of Traumatic Surgery

摘　　要：目的分析Sureshot远端瞄准系统进行股骨髓内钉远端锁钉操作的临床应用价值。方法回顾性分析沈阳市第四人民医院2013年2月-2015年8月收治的股骨干骨折患者92例,均具有股骨髓内钉置入治疗的指征。按照置入方法的不同分为磁力导航交锁髓内钉组(EM组)和徒手髓内钉远端锁钉组(FH组),EM组40例,采用磁力导航(Electromagnetic)交锁髓内钉治疗,即Sureshot远端瞄准系统;FH组52例,采取徒手远端锁钉技术。所有患者均随访3~12个月,记录并比较两组患者术中评价指标:远端2枚锁钉锁定耗时、术中X线片透视时间、术中失血量、骨折愈合时间、一次性锁定成功率等;比较两组患者感染、断钉、骨折不愈合、肢体短缩、再骨折等并发症的发生率及Lysholm评分。结果 EM组远端2枚螺钉锁定时间为(7.74±2.02)min,术中X线透视时间(17.58±5.76)min,失血量(210.84±63.28)mL,一次性锁定成功率为95.00%,均显著优于FH组[(20.21±5.18)min,(42.28±15.24)min,(375.36±94.27)mL,76.92%],差异有统计学意义(P<0.05);EM组骨折愈合时间(16.66±1.84)周,与FH组差异无统计学意义;EM组总并发症发生率为7.50%,优良率为95.00%,与FH组差异无统计学意义(15.38%,94.23%,P>0.05)。结论Sureshot远端瞄准系统是一种比较理想的髓内钉远端锁定技术,拥有锁定时间短、一次性成功率高、术中失血量少、X线片透视时间少等优点,安全可靠。Objective To analyze the clinical application value of Sureshot Distal Targeting System in loc- king intrameduallary nail operation for femoral shaft fracture. Methods Clinical data of 92 patients with femoral shaft fracture from Feb. 2013 to Aug. 2015 in our hospital, who had indications of intramedullary nail implantation, was retrospectively analyzed and divided into two groups according to the methods of implantation ： the EM group （ n = 40 ） with magnetic navigation interlocking intramedullary nail technology （ also known as Sureshot Distal Targeting System） and the FH group（n = 52） with freehand distal locking nail technology. All the patients were followed up from 3 months to 1 year. The evaluation indexes of two groups, such as the duration of successful locking of nails, duration of intraoperative fluoroscopy, loss of blood, fracture union time and one - time successful rate, were com- pared. Incidence of ilfflcction, broken nail, fracture nonunion, limb shortening and fracture recurrence, and Ly- sholm scores were compared between the two groups. Results The duration of successful locking of nails （ 7.74 ± 2.02min）, duration of intraoperative fluoroscopy （ 17.58 ± 5.76 ） min, loss of blood （ 210.84 ± 63.28 ） mL and one - time successful rate（95.00% ） in EM group were superior to these in HF group（ P 〈0.05 ） ; and the incidence of complications （7.50%） and excellent and good rate（ 95.00% ） in EM group were found not significantly different compared with the FH group, P 〉 0.05. Conclusion Sureshot Distal Targeting System is an ideal technology of locking intramedullary nail, with low duration of locking nail, high rate of one - time successful locking, low loss of blood, short fracture union time, short intraoperative fluoroscopy and low rate of complication, which is safe and re- liable.

关 键 词：股骨骨折 远端瞄准系统 髓内钉 锁钉 

分 类 号：R683.42[医药卫生—骨科学]