计算机导航系统置钉结合术中三维CT修复重建骨盆骨折:与传统C臂透视辅助的对比

Computer navigation system plus intro-operative 3D imaging system for the reconstruction of pelvic fractures:A comparison with traditional C-arm perspective assisted operation

背景:计算机导航系统结合术中三维CT为目前骨科植入物置入治疗中的先进配备,相比二维、三维X射线导航更微创、更精确、更安全。目的:比较计算机导航系统结合术中三维CT与C臂透视辅助下手术治疗骨盆骨折中置入钢板、螺钉的精确性及安全性。方法:对56例骨盆骨折患者进行钢板及螺钉置入内固定治疗,按照患者意愿分为2组。对照组以传统C臂透视为辅助手段;实验组以计算机导航系统结合术中三维CT为辅助手段。比较两组患者手术时间、术中出血量、引流量、输血量、切口长度、透视时间、复位及功能恢复情况。结果与结论:实验组术中出血量、输血量、切口长度和透视时间均低于对照组(P<0.05),两组间手术时间、复位满意程度的差异无显著性意义(P>0.05)。56例病例中1例失访,55例获得随访,随访1.7(1～4)年。两组骨折均愈合,无延迟愈合或不愈合。术后8个月两组功能恢复差异无显著性意义(P>0.05)。证实以计算机导航系统结合术中三维CT为辅助手段内固定治疗骨盆骨折手术具有微创、精确的特点,对患者和医疗人员更加安全,术后复位固定满意,远期功能恢复较好。

BACKGROUND：Computer navigation plus intro-operative 3D imaging system is advanced device in the treatment of current orthopedic implants.Compared to two-dimensional,three-dimensional X-ray navigation is more minimally invasive,more accurate and safer.OBJECTIVE：To compare the accuracy and safety of placing plates and screws by computer navigation plus intro-operative 3D imaging system and C-arm fluoroscopy assisted treating pelvic fracture.METHODS：Surgical fixation of 58 cases of pelvic fracture was divided into two groups.The control group was treated with traditional C-arm,and test group was treated with computer navigation plus intro-operative 3D imaging system.Operative time,blood loss,blood transfusion,incision length,fluoroscopy time,reduction and functional recovery in cases were compared.RESULTS AND CONCLUSION：Test group was lower than control group in blood loss,blood transfusion,incision length and fluoroscopy time（P 0.05）.Two groups showed no significant difference in operating time or reduction satisfaction（P 0.05）.Except for 1 lost,55 patients were followed up for 1-4 years（average 1.7 years）.All fractures were healed,and no delayed union or nonunion.Functional recovery after 8 months showed no significant difference between two groups（P 0.05）.Computer navigation plus intro-operative 3D imaging system assisted pelvic fracture fixation is minimally invasive and precise,and safety to patients and medical staff.Moreover,it exhibits satisfactory reduction and fixation,as well as good long-term functional recovery.