计算机导航辅助下转子间骨折的微创治疗

Treatment of Intertrochanteric Fracture with Minimal Invasive Surgery Assisted by Computer Navigation System

目的利用计算机导航定位、引导,实现股骨转子间骨折固定手术的微创化。方法自2006年8月至2010年9月,我院共收治了84例股骨转子间骨折患者,79例为新鲜外伤性骨折。其中76例采用透视下闭合复位,近端髓内固定手术,男28例,女48例;年龄59～96岁,平均76.8岁。76例中27例选择了术中导航辅助下内固定,其余49例采用常规方法内固定。两组患者均存在不同程度的骨质疏松,均有内科并存症。对比两组患者手术时间、术中显性出血量、术中曝光次数、手术创口大小。结果两组在术中显性出血量、术中曝光次数、手术创口大小等方面进行比较,导航组均优于常规内固定组,差异有统计学意义(P<0.05)。结论闭合复位,导航辅助可以作为内固定手术治疗股骨转子间骨折的微创方法,可以使手术定位准确,内固定位置更理想,减少术中失血及X线的曝光次数。

Objective Using computer navigation system helps to minimize the invasion of intertrochanteric fracture internal fixation operation.Methods From August 2006 to September 2010,we had treated 84 cases of intertrochanteric fracture in our hospital.76 cases（28 male,48 female） were treated with the intramedullary nail（Garma nail,PFNA nail and EPFN nail）.The patients aged from 59～96 years,with an average of 76.8 years old.In 27 of them,fracture was fixed assisted by computer navigation system,and the others undergone routine procedure.The operation time,blood loss,times of X-ray during operation and the size of the incision were compared between the two groups.Results The data shows that the computer-assisted group had less blood loss,shorter the exposure time under the X-ray and smaller size of the incision.Conclusion The computer navigation assisted fixation of the intertrochanteric fracture is a minimall invasive choice.