磁力导航交锁髓内钉治疗胫骨干骨折

Magnetic Navigation for Interlocking Intramednllary Nailing in the Treatment of Tibial Shaft Fracture

目的评价磁力导航交锁髓内钉治疗胫骨干骨折的疗效,并与普通交锁髓内钉疗效进行比较。方法将60例胫骨干骨折患者随机分为两组:A组30例,使用磁力导航交锁髓内钉治疗;B组30例,使用普通交锁髓内钉治疗。记录两组远端2枚锁钉锁定成功时间,一次性锁定成功率。对两组分别就其平均手术时间、骨折平均愈合时间、HSSknee rating score法评定功能的各项指标进行比较分析。结果远端2枚锁钉锁定成功时间:A组(7.9±3.7)min,B组(18.1±4.8)min,两组差异有统计学意义(t=15.78,P<0.05);一次性锁定成功率:A组97%,B组78%,两组差异有统计学意义(t=10.01,P<0.05);A组骨折延迟愈合1例,骨折短缩移位1例;B组断钉1例,伤口浅表感染1例,骨折延迟愈合3例。两组手术时间、术中出血量、并发症及HSS knee rating score法评定功能恢复优良率比较,差异有统计学意义(t=17.32,14.75,7.46,P<0.05)。结论磁力导航交锁髓内钉治疗胫骨干骨折疗效满意,与普通交锁髓内钉比较有定位准确、手术时间短、创伤小的优势。

Objective To evaluate the effect of magnetic navigation for interlocking intramedullary nailing in the treatment of tibial shaft fracture and compare it with the effect of common interlocking intramedullary nail. Methods 60 cases were divided into two groups. 30cases in group A were treated with magnetic navigation interlocking in tramedullary nail and 30 cases in group B were treated with common interlocking intramedullary nail. Time consump tion of suceessfull distal nail locking,one-time locking ratio in two groups were observed. The two groups were evalu- ated with the average operation time ,the healing time,HSS kneerating score. Results The average time consumption of successful distal nail locking was（7.9!3.7） minutes in group A and（18, l!4.8） minutes in group B. There was statistical difference between two groups （t = 15. 78, P〈 0. 05）. The average one-time locking ratio A was 97~in group and 78 ~in group B. There was statistical difference （t--10.01 ,P%O. 05）. In group A ,there were one breakage of the screws ,one superficial infection and the other 3 delayed bone healing. In the group B,there were found one de layed bone healing and one short dislocation. The average operation time,operation blooding volume ,the healing time, implications and the excellent rate of function recovery by HSS knee rating score was significantly difference between two groups （t =17.32,14.75,7.46,P〈0.05）. Conclusion Good effect can be achieved in magnetic navigation inter locking intramedullary nail in the treatment of tibial shaft fracture,which has advantages of more accurate position, less operation time and less trauma compared with common intedocking intramedullary nail.