股骨干骨折髓内钉固定三种远端锁定置入比较
Comparison of three distal locking screw placement in intramedullary nailing fixation of femoral shaft fracture
林旺 1林小龙 2王盈盈 1冯彬 1郭卫中 1林成寿1
作者信息
- 1. 福建医科大学附属闽东医院,福建福安 355000
- 2. 福建医科大学,福建福州 350000
- 折叠
摘要
[目的]对比采用常规机械式瞄准器、2枚斯氏针透视技术及国产可视化电磁导航系统置入股骨髓内针远端锁钉的手术效能.[方法]回顾性分析2018年1月—2022年7月采用交锁髓内针内固定治疗的45例成人股骨干骨折患者的临床资料.根据医患沟通结果将患者分为常规组(机械式瞄准器)、导针组(2枚斯氏针透视技术)及导航组(可视化电磁导航).每组15例.比较三组手术效能.[结果]所有患者均顺利完成手术.常规组、导针组和导航组的手术时间为[(150.5±39.5)min vs(118.3±31.4)min vs(113.3±29.5)min,P=0.008],远端切口 总长度[(5.2±0.3)cm vs(4.0±0.3)cm vs(4.1±0.2)cm,P＜0.001],远端锁钉时间[(39.3±12.3)min vs(32.1±7.7)min vs(30.1±6.1)min,P=0.020],远端锁钉透视次数[(8.1±2.6)次 vs(10.3±2.4)次 vs(4.3±1.0)次,P＜0.001],远侧孔一次成功率(66.7％vs 80.0％vs 100％,P=0.042).术后1周常规组、导针组和导航组的VAS评分为[(4.8±0.7)vs(3.7±0.7)vs(3.5±0.6),P＜0.001],末次随访时,三组VAS评分的差异均无统计学意义(P＞0.05).[结论]对比常规机械式瞄准器,2枚斯氏针技术和国产可视化电磁导航系统均可提升手术效能,缩短远端螺钉置入时间和整体手术时间.
Abstract
[Objective]To compare the surgical efficacy of distal locking screw placement among conventional mechanical guide(CMG),two pin fluoroscopy(TPF)and domestic visual electromagnetic navigation system(EMN).[Methods]A retrospective study was per-formed on 45 adult patients who received interlocking intramedullary nailing for femoral shaft fractures from January 2018 to July 2022.Ac-cording to the doctor-patient communication,the patients were divided into a CMG,TPF and EMN groups,with 15 cases in each group.The operative efficacy of the three groups was compared.[Results]All patients in the 3 groups had operation performed successfully.The CMG,TPF and EMC group were recorded in terms of operation time[(150.5±39.5)min vs(118.3±31.4)min vs(113.3±29.5)min,P=0.008],total length of the distal incision[(5.2±0.3)cm vs(4.0±0.3)cm vs(4.1±0.2)cm,P＜0.001],distal locking time[(39.3±12.3)min vs(32.1±7.7)min vs(30.1±6.1)min,P=0.020],fluoroscopy times for distal locking[(8.1±2.6)times vs(10.3±2.4)times vs(4.3±1.0)times,P＜0.001],and the success rate of the first screw placement of the distal hole(66.7％vs 80.0％vs 100％,P=0.042).The VAS scores for pain of the CMG,TPF and EMC groups were[(4.8±0.7)vs(3.7±0.7)vs(3.5±0.6),P＜0.001]one week after surgery,while which became not statistically signif-icant among the three groups at the latest follow-up(P＞0.05).[Conclusion]Compared with the conventional mechanical guide,both two pin fluoroscopy and visual electromagnetic navigation system do improve operation efficacy in shortening the time of distal screw placement and shortening the total operation time.
关键词
可视化电磁导航/股骨干骨折/锁定髓内针/远端锁定Key words
visual electromagnetic navigation/femoral shaft fracture/interlocking intramedullary nail/distal locking引用本文复制引用
基金项目
2020年福建省自然科学基金项目(2020J011334)
出版年
2024
NETL
NSTL
万方数据