基于误差纠正算法的计算机辅助股骨颈骨折空心螺钉内固定系统的临床应用研究

发布时间：2018-03-31 19:30

本文选题：计算机辅助骨科手术　切入点：股骨颈骨折　出处：《中国修复重建外科杂志》2017年03期

【摘要】：目的探讨基于误差纠正算法的计算机辅助股骨颈骨折空心螺钉内固定系统的临床应用价值。方法回顾性分析2014年1月—2015年10月,采用基于误差纠正算法的计算机辅助股骨颈骨折空心螺钉内固定系统完成股骨颈骨折闭合复位空心螺钉内固定术的20例患者临床资料(试验组),并与同期采用传统徒手植钉法完成手术的36例患者(对照组)进行比较。两组患者性别、年龄、致伤原因、骨折侧别、骨折类型、受伤至手术时间等一般资料比较,差异均无统计学意义(P0.05),具有可比性。比较两组手术时间、术中出血量、术中透视次数、术中钻入导针次数、骨折愈合时间、骨折愈合率以及髋关节Harris评分。结果两组术后切口均Ⅰ期愈合,无神经、血管损伤等并发症发生。试验组手术时间较对照组显著延长(t=2.290,P=0.026),但术中出血量、术中透视次数、术中钻入导针次数均较对照组显著降低,比较差异有统计学意义(t= 10.650,P=0.000;t=18.320,P=0.000;t= 16.625,P=0.000)。所有患者术后均获随访,随访时间12~18个月,平均14.7个月。X线片复查示,两组骨折均愈合,且骨折愈合时间比较差异无统计学意义(t=0.208,P=0.836);随访期间无股骨头缺血性坏死等并发症发生。末次随访时,试验组髋关节Harris评分为(87.05±3.12)分,对照组为(86.78±2.83)分,比较差异无统计学意义(t=0.333,P=0.741)。结论与传统徒手植钉手术相比,采用基于误差纠正算法的计算机辅助股骨颈骨折空心螺钉内固定系统辅助手术在减少术中辐射、减小手术创伤等方面具有一定优势。
[Abstract]:Objective to explore the clinical application value of computer-aided hollow screw fixation system for femoral neck fracture based on error correction algorithm. Methods retrospective analysis was made from January 2014 to October 2015. Clinical data of 20 cases of closed reduction and Hollow Screw Internal Fixation of femoral neck fractures completed by computer aided Hollow Screw Internal Fixation system based on error Correction algorithm. A comparison was made between 36 patients (control group) who underwent the operation with bare hand nail implantation. Age, cause of injury, fracture side, fracture type, injury to operation time and other general data, the differences were not statistically significant (P 0.05), compared the two groups of operation time, intraoperative blood loss, intraoperative fluoroscopy times, and so on. Results the times of penetration, the time of fracture healing, the rate of fracture healing and the score of Harris of hip joint were obtained. Compared with the control group, the operative time of the experimental group was significantly longer than that of the control group, but the amount of blood loss, the times of fluoroscopy and the times of penetration of the guide needle were significantly lower in the experimental group than in the control group. The difference was statistically significant (t = 10.650 ~ 0.000 ~ 18.320 / t = 16.625 ~ 0.000). All the patients were followed up for 12 ~ 18 months with an average of 14.7 months. The fracture healed in both groups. There was no significant difference in fracture healing time between the two groups. There were no complications such as avascular necrosis of femoral head during the follow-up. The Harris score of hip joint in the trial group was 87.05 卤3.12 at the last follow-up, and that in the control group was 86.78 卤2.83). There was no statistical difference between the two groups. Conclusion compared with the traditional bare-hand nail grafting, the computer-aided internal fixation system for femoral neck fractures with hollow screw fixation system based on error correction algorithm can reduce the radiation during operation. It has some advantages in reducing surgical trauma and so on.
【作者单位】：中国人民解放军总医院骨科;北京航空航天大学机器人研究所;
【基金】：全军医学科研“十二五”计划课题资助项目(BWS11J113) 国家高技术研究发展计划(863)资助项目(2015AA043204、2015AA043201) 中国人民解放军总医院科技创新苗圃基金资助项目(16KMM21)~~
【分类号】：R687.3

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