电磁导航系统定位胫骨髓内钉远端锁定治疗胫骨骨折的疗效观察  

Clinical efficacy of electromagnetic navigation system in distal locking of tibia intramedullary nail

作　　者：吴晗 许新忠[1] 程文丹[1] 吕浩[1] 荆珏华[1] WU Han;XU Xin-zhong;CHENG Wen-dan;LU Hao;JING Jue-hua(Second Department of Orthopedics,Second Affiliated Hospital of Anhui Medical University,Hefei Anhui 230000,China)

机构地区：[1]安徽医科大学第二附属医院骨二科,安徽合肥230000

出　　处：《局解手术学杂志》2019年第1期34-37,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨电磁导航系统定位胫骨髓内钉的远端锁定螺钉治疗闭合性胫骨骨干骨折的临床效果。方法选择2010年2月至2016年12月在安徽医科大学第二附属医院骨科行胫骨干骨折髓内钉内固定手术治疗的79例患者,按照髓内钉锁定方式不同将其分为导航锁定组和徒手锁定组。导航锁定组44例患者采用电磁导航系统进行髓内钉的远端锁定,徒手锁定组35例患者使用自由手技术远端锁定,比较2组患者术中X射线暴露时间、远端锁定时间、骨折愈合时间以及一次性远端锁定的成功率。结果导航锁定组较徒手锁定组在远端锁定螺钉的平均手术时间、辐射暴露时间均明显减少,差异具有统计学意义(P<0.05);导航锁定组一次性远端锁定的成功率为100%,明显高于徒手锁定组的37.34%,2组比较差异具有统计学意义(P<0.05); 2组骨折愈合时间差异无统计学意义(P>0.05)。结论与自由手技术相比较,利用电磁导航系统对胫骨髓内钉进行远端锁定具有锁定时间短、效率高、无辐射的优点。Objective To evaluate the clinical effect of electromagnetic navigation system to locate the distal locking screw of tibia intramedullary nail.Methods From February 2010 to December 2016,79 cases of tibia shaft fractures requiring treatment with intramedullary nailing were selected and divided into the navigation group and free hand locking group according to intramedullary nail locking methods.Forty-four cases in navigation group used an electromagnetic navigation system to lock the distal end of the intramedullary nail,while 35 cases in free hand locking group used a free-hand technique.The intraoperative X-ray exposure time,distal locking time,healing time,and the success rate of one-time distal locking were recorded compared between two groups.Results The average time of diatal locking using electromagnetic navigation technology was less than that of the free hand locking group,and the exposure time of fluoroscopy was also reduced,the differences were significant(P<0.05).There was no difference in fracture healing time between the two groups(P>0.05),one-time success rate of navigation group was 100%,which was higher than 37.34%of the free hand locking group,the difference was significant(P<0.05).Conclusion Compared with free hand technology,the advantage of using electromagnetic navigation system to lock the distal nail of tibia intramedullary nail is high efficiency,short locking time and no radiation.

关 键 词：髓内钉 胫骨骨折 自由手技术 电磁导航系统 辐射暴露 内固定术 微创手术 生物学内固定 

分 类 号：R658.3[医药卫生—外科学]