虚拟现实技术联合股骨头缩小成形术治疗扁平髋的研究  

Study of virtual reality technology combined with reduction plasty of femoral head in treatment of coxa plana

作　　者：邱越 夏天卫 袁兆丰 环大维 张超 沈计荣 QIU Yue;XIA Tianwei;YUAN Zhaofeng;HUAN Dawei;ZHANG Chao;SHEN Jirong(Department of Traumatology&Orthopedics,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing Jiangsu,210029,P.R.China)

机构地区：[1]南京中医药大学附属医院骨伤科,南京210029

出　　处：《中国修复重建外科杂志》2023年第3期284-289,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨虚拟现实技术(virtual reality,VR)联合股骨头缩小成形术治疗扁平髋的可行性,并评估其临床疗效。方法以2018年10月—2020年10月收治的3例扁平髋男性患者为研究对象,年龄为15~24岁。术前应用VR技术行手术规划,将髋关节256排CT数据导入软件,生成三维图像,模拟手术过程,确定头臼匹配关系。术中依据术前规划行外科脱位下股骨头缩小成形术、股骨颈相对延长术及髋臼周围截骨术,透视下确认股骨头缩小截骨大小和髋臼旋转角度。术后影像学复查评估截骨愈合情况;记录患者手术前后髋关节功能Harris评分、疼痛视觉模拟评分(VAS);根据X线片测量股骨头圆形指数、髋关节中心边缘(center-edge,CE)角、股骨头覆盖率。结果3例患者顺利完成手术,手术时间分别为460、450、435 min,出血量分别为733、716、829 mL;术前VR技术设计股骨头缩小截骨大小分别为9.87、12.42、14.59 mm,术中实际截骨大小为11.4、9.4、12.2 mm,两者相差1.53、3.02、2.39 mm。术后均输注3 U悬浮少白红细胞和300 mL冰冻病毒灭活血浆。术后未出现感染、双下肢深静脉血栓形成等并发症。3例患者均获随访,随访时间分别为25、30、15个月;3个月时复查CT示截骨处均愈合良好。术后12个月及末次随访时VAS评分和Harris评分,以及术后12个月股骨头圆形指数、髋关节CE角、股骨头覆盖率均较术前明显改善;术后12个月根据Harris评分评价3例髋关节功能均获良。结论VR技术联合股骨头缩小成形术治疗扁平髋可获得满意的早期疗效。Objective To explore the feasibility of virtual reality(VR)technology combined with reduction plasty of the femoral head in the treatment of coxa plana and evaluate its effectiveness.Methods Three patients with coxa plana were selected as the research objects between October 2018 and October 2020,all of them were male,aged 15-24 years.Preoperative surgical planning was performed using VR technology;256 rows of CT data of hip joint were imported into software to generate three-dimensional(3D)imaging,simulate the surgical process,and determine the matching relationship between the femoral head and acetabulum.According to the preoperative planning,reduction plasty of the femoral head under surgical dislocation,relative lengthening of the femoral neck,and periacetabular osteotomy were performed.The reduction of osteotomy size of femoral head and rotation angle of acetabulum were confirmed by C-arm fluoroscopy.The healing of the osteotomy were assessed by radiological examination after operation.The Harris score of hip function and visual analogue scale(VAS)score were recorded before and after operation.The femoral head roundness index,center-edge(CE)angle,and femoral head coverage were measured by X-ray films.Results Three operations were completed successfully,and the operation time was 460,450,and 435 minutes,and the intraoperative blood loss was 733,716,and 829 mL,respectively.All patients were infused with 3 U suspension oligoleucocyte and 300 mL frozen virus inactivated plasma after operation.No postoperative complication occurred,such as infection and deep vein thrombosis.Three patients were followed up 25,30,and 15 months,respectively.CT showed good healing of the osteotomy at 3 months after operation.The VAS score and Harris score at 12 months after operation and at last follow-up,as well as the femoral head rounding index,hip CE angle,and femoral head coverage at 12 months after operation significantly improved when compared with those before operation;the hip function was evaluated by the Harris score at 12

关 键 词：虚拟现实技术 股骨头缩小成形术 扁平髋 

分 类 号：R687.3[医药卫生—骨科学]