G型臂X线机在股骨颈骨折空心钉置入中的应用价值

Application Value of G-arm X-ray Machine in Placement of Cannulated Screws for Femoral Neck Fracture

目的:探讨G型臂X线机辅助经皮微创置钉在股骨颈骨折空心钉固定术中的应用价值。方法:回顾性收集64例采用经皮空心钉固定治疗的成人股骨颈骨折患者的资料。其中33例术中采用G型臂X线机透视下辅助置钉,为G臂组;31例术中采用C型臂X线机透视下辅助置钉,为C臂组。采用Harris评分评估髋关节功能情况,比较2组术中操作X线机次数、手术时间、术后住院时间、末次随访时疼痛视觉模拟评分及Harris评分。结果:2组手术均顺利完成,G臂组解剖复位31例,功能复位2例;C臂组解剖复位28例,功能复位3例。64例获得随访,平均随访(5.7±0.6)个月。G臂组术中操作X线机次数(t=6.287,P=0.000)、手术时间(t=6.482,P=0.000)少于C臂组(P<0.05);2组术后住院时间(t=0.568,P=0.571)、末次随访时疼痛视觉模拟评分(t=0.530,P=0.597)及Harris评分(t=0.714,P=0.477)差异均无统计学意义(P>0.05)。结论:股骨颈骨折空心钉固定术中采用G型臂X线机辅助置钉,具有中术操作X线机次数少、手术时间短的优点,可取得满意治疗效果。

Objective To investigate the value of G-arm X-ray machine assisted percutaneous minimally invasive screw fixation in cannulated screws of femoral neck fractures. Methods The adult femoral neck fractures (64 cases) treated with percutaneous cannulated screws were retrospectively collected. Thirty-three cases assisted by fluoroscopy of G-arm X-ray machine in the placement of percutaneous cannulated screws were recorded as the G-arm group. Thirty-one cases assisted by fluoroscopy of C-arm X-ray machine in the placement of percutaneous cannulated screws were recorded as the C-arm group. Harris score was used to evaluate the hip function. The intraoperative operating X-ray machine times, operative time, postoperative hospital stay, pain visual analogue score and Harris score at the last follow-up were compared. Results Both group' s operations were successfully completed. The G-arm group had 31 cases of anatomical reduction, 2 cases of functional reduction, while the C-arm group had 28 cases of anatomical reduction and 3 cases of functional reduction. All patients were followed up for an average of (5.7±0.6) months. In the G-arm group, the intraoperative operating X-ray machine times (t =6.287, P =0.000) and operation time (t =6.482, P =0.000) were less than those in the C-arm group (P <0.05). There was no significant difference in the postoperative hospital stay (t =0.568, P =0.571), pain visual analogue scale (t =0.530, P =0.597) and Harris score (t =0.714, P =0.477) at the last follow-up between the two groups (P >0.05). Conclusion The use of G-arm X-ray machine assisted the placement during cannulated screws fixation for femoral neck fractures has the advantages of fewer intraoperative operating X-ray machine times and shorter operative time, and can achieve satisfactory therapeutic results.