股骨交锁髓内钉远端锁钉体外透视定位器的研制及临床应用  

Development and clinical application of a novel fluoroscopically localizer for distal locking of femoral interlocking intramedullary nail

作　　者：陈立军 庞清江[2] 余霄[2] 沈追孟 褚武 方丹丹 CHEN Li-jun;PANG Qing-jiang;YU Xiao(Cilin Hospital, Ningbo 315315, China)

机构地区：[1]浙江省宁波市慈林医院,浙江宁波315315 [2]宁波市第二医院,浙江宁波315010

出　　处：《中国矫形外科杂志》2018年第8期757-761,共5页Orthopedic Journal of China

摘　　要：[目的]研制股骨交锁髓内钉远端锁钉体外透视定位器,探讨其在治疗股骨干骨折手术中远端锁钉的疗效。[方法]2012年10月~2016年1月收治的股骨干骨折行交锁髓内钉手术内固定患者220例,在进行远端锁钉操作时发生锁钉失败64例,随机分为调节定位器组和徒手组。调节定位器组(33例)用自制定位器进行远端锁钉,徒手组(31例)采用透视下徒手髓内钉远端瞄准方法。所有患者术后随访13~18个月,平均15.1个月。比较两组手术中的远端锁钉时间、锁钉成功率、透视时间、术中出血量。[结果]调节定位器组与徒手组相比较,在远端锁钉时间[(4.61±1.71)mins vs(17.06±2.57)min,P<0.05],锁钉成功率(100%vs 89%,P<0.05),透视时间[(2.06±1.22)min vs(12.87±2.85)min,P<0.05],术中出血量[(210.27±13.94)ml vs(381.00±27.75)ml,P<0.05],两组间差异均具有统计学意义。[结论]该定位器与原有机械定位系统匹配良好,是常规机械远端锁钉失败时有效的替代定位器。[Objective] To evaluate the efficacy of a new developed external localizer for distal locking of intramedullary interlocking nail for femoral shaft fracture. [Methods] From October 2012 to January 2016, 220 patients received interlocking intramedullary nailing for femoral shaft fracture. Of them, 64 patients who failed in distal locking of the nail with the conventional technique were randomly divided into two groups： the localizer group that had the nail locked with this new developed apparatus in 33 patients, while the free-hand group that had the locking done by hand in 31 patients. The two groups were compared in distal locking time, successful rate of locking, fluoroscopy time and intraoperative bleeding. [Results] Compared the localizer group with the freehand group, there were statistically significant differences in distal locking time [（4.61±1.71） min versus（17.06±2.57） min, P〈0.05], successful rate of locking（100% versus 89%, P〈0.05）, fluoroscopy time [（2.06±1.22） mins versus（12.87±2.85） mins, P〈0.05] and intraoperative bleeding [（210.27±13.94） ml versus（381.00±27.75） ml, P〈0.05]. [Conclusion]This new developed fluoroscopically localizer is well matched with the previous mechanical positioning system. Therefore, it is effective alternative in case of conventional positioning failure.

关 键 词：交锁髓内钉 远端锁定 定位器 透视 

分 类 号：R687[医药卫生—骨科学]