数字化导航模板在Salter截骨术中的临床应用

发布时间：2018-10-25 19:13

【摘要】：目的利用数字化技术为Salter截骨术设计一种导航模板,并探讨其临床应用效果。方法自2012年4月~2015年6月,收集21例单侧发育性髋关节脱位行Salter截骨术患儿的术前骨盆CT原始数据,应用数字化技术,模拟Salter截骨术,设计并生产辅助截取三角形髂骨植骨块的导航模板,辅助术中截骨。分析双侧髋关节手术前后及末次随访的髋臼指数(AI),采用Mckay临床疗效评定标准和Severin X线评定标准评定手术疗效。结果双侧髋关节手术前后及末次随访的髋臼指数进行重复测量因素的方差分析,不同测量时间之间(F=357.72,P=0.00)、部位之间(F=221.05,P=0.00)存在显著的主效应。时间与部位之间存在显著的交互效应(F=1984.82,P=0.00)。所有时间水平间均存在显著差异(P=0.00)。Pearson相关性分析表明,患侧髋臼指数术后改善的角度与导航模板的角度或三角形髂骨植骨块顶角的角度均成正相关,相关系数分别为(r=0.91,P=0.00)及(r=0.96,P=0.00)。改良Severin影像学分类为优14例、良5例、可2例,优良率90.48%。改良Mckay功能评价为优13例、良7例、可1例,优良率95.24%。结论数字化导航模板可辅助Salter截骨术快速、精确截取三角形髂骨植骨块,提高手术精确度和成功率,缩短手术时间。
[Abstract]:Objective to design a navigation template for Salter osteotomy by digital technique and discuss its clinical application. Methods from April 2012 to June 2015, 21 children with unilateral developmental dislocation of hip underwent Salter osteotomy. The original data of pelvic CT were collected and simulated by digital technique. A navigation template was designed and produced to assist the extraction of triangular iliac bone graft. The acetabular index (AI),) before and after bilateral hip surgery was evaluated by Mckay and Severin X ray. Results the analysis of variance of repeated measurement of acetabular index before and after bilateral hip surgery and the last follow-up showed that there were significant main effects between different measuring time (FN 357.72), and between sites (FN 221.05% P0.00). There was significant interaction between time and site (FV 1984.82 P0.00). Significant differences were found in all time levels (P 0. 00). Pearson correlation analysis showed that the improvement of acetabular index after operation was positively correlated with the angle of the navigation template or the angle of the parietal angle of the triangular iliac bone graft. The correlation coefficients were (0.91%) and (0.96%) respectively. The improved Severin classification was excellent in 14 cases, good in 5 cases and fair in 2 cases. The excellent and good rate was 90.48%. The improved Mckay function was excellent in 13 cases, good in 7 cases and fair in 1 case. The excellent and good rate was 95.24%. Conclusion the digital navigation template can be used to assist Salter osteotomy. The triangular iliac bone graft can be obtained accurately. The accuracy and success rate of the operation can be improved and the operation time can be shortened.
【作者单位】：东莞市中医院骨科;东莞市茶山医院骨科;南方医科大学第三附属医院(广东省骨科研究院)儿童骨科;
【基金】：广东省东莞市医疗卫生科技计划重点项目(2011105102005)
【分类号】：R726.8

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