股骨近端防旋髓内钉三维导航器的临床应用

Clinical application of the 3D proximal femoral nail anti-rotation navigator

目的探讨股骨近端防旋髓内钉（PFNA）置入导航技术.方法自2013年12月至2015年6月,在本课题组研制的PFNA 三维导航器导航下置入PFNA 治疗股骨粗隆间骨折56 例,其中男19 例,女37 例;年龄55～92 岁,平均（72.2±1.8）岁.顺型骨折51例,逆型骨折5例.受伤至手术时间为2～8d,平均（4.2±1.4）d.结果在PFNA 三维导航器导航下向股骨头颈部打入的动力钉导引针均一次性置入,在髋关节侧位X 线片上动力钉导引针偏离股骨中心点的垂直距离为0～4mm,平均（1.75±1.37）mm.结论本课题组研制的PFNA 三维导航器精准性高,能一次性打入动力钉导引针,其误差微小,完全能满足临床需求.

Objective To discuss the navigation technology of the proximal femoral nail anti-rotation(PFNA)insertion.Methods From December 2013 to June 2015,56 cases of the intertrochanteric fractures were treated with the 3D PFNA navigator which was developed to place PFNA.There were 19 cases of males and 37 cases of females,with an average age of 72.2±1.8 years(range,55-92 years).There were 51 cases of down type fracture and 5 cases of inverse type fracture.The time interval from injury to the operation was 2 to 8 days(average,4.2±1.4 days).Results The power nail and guiding needle which drived into the femoral head were all one-time insertion under the 3D PFNA navigator.At the lateral position of hip joint,the distance of the power nail and guiding needle deviating from the center of the femoral head was0-4 mm(average,1.75±1.37 mm).Conclusion The 3D PFNA navigator has high precision,it can drive the power nail and guiding needle directly with miniature error.