CAJ | 학술논문

背景：文献报道采用X射线透视下经皮空心螺钉治疗骨盆髋臼骨折，但其内固定时间长，且患者与医生的放射暴露量大。 　　目的：评价ISO-C3D计算机辅助导航微创技术在髋臼骨折治疗中的应用效果。 　　方法：采用计算机辅助导航下经皮微创内固定治疗骨盆髋臼骨折31例，患者伤后至内固定时间为4-13 d。所有患者随访满1年。 　　结果与结论：患者内固定治疗中除1例伴有骶髂关节损伤行切开复位内固定患者出血量约300 mL，其余患者平均出血量18 mL。内固定中共置入螺钉42枚，髋臼前柱骨折螺钉24枚，后柱螺钉18枚，所有螺钉均一次性准确置入。平均内固定时间59 min，平均透视时间为39 s。31例患者治疗后1周疼痛明显减轻，均无感染、血管神经损伤、内固定物断裂等并发症发生。至随访结束，摄X射线片示骨折愈合，无螺钉断裂及松动，根据Matta临床评分标准，优23例，良8例，优良率100%。内固定后髋关节功能根据Majeed 评分系统：优22例，良6例，可3例，优良率90%。提示ISO-C3D计算机辅助导航技术经皮微创内固定治疗可实现坚强内固定，且治疗中创伤小，内固定后并发症较少。
배경：문헌보도채용X사선투시하경피공심라정치료골분관구골절，단기내고정시간장，차환자여의생적방사폭로량대。 　　목적：평개ISO-C3D계산궤보조도항미창기술재관구골절치료중적응용효과。 　　방법：채용계산궤보조도항하경피미창내고정치료골분관구골절31례，환자상후지내고정시간위4-13 d。소유환자수방만1년。 　　결과여결론：환자내고정치료중제1례반유저가관절손상행절개복위내고정환자출혈량약300 mL，기여환자평균출혈량18 mL。내고정중공치입라정42매，관구전주골절라정24매，후주라정18매，소유라정균일차성준학치입。평균내고정시간59 min，평균투시시간위39 s。31례환자치료후1주동통명현감경，균무감염、혈관신경손상、내고정물단렬등병발증발생。지수방결속，섭X사선편시골절유합，무라정단렬급송동，근거Matta림상평분표준，우23례，량8례，우량솔100%。내고정후관관절공능근거Majeed 평분계통：우22례，량6례，가3례，우량솔90%。제시ISO-C3D계산궤보조도항기술경피미창내고정치료가실현견강내고정，차치료중창상소，내고정후병발증교소。
BACKGROUND:Percutaneous hol ow screw under X-Ray fluoroscopy has been shown to treat fracture of acetabulum of the pelvis, but the time of internal fixation was long, and the amount of radiation exposure to the patients and physicians was large. OBJECTIVE:To test the application of the ISO-C3D METHODS:Thirty-one patients with fracture of the acetabulum were treated with percutaneous hol ow screw under a fluoroscopy-based ISO-C computerized navigational system for fracture of acetabulum. 3D computerized navigational system. The interval from injury to operation was 4 to 13 days. Al patients were fol owed up for one year. RESULTS AND CONCLUSION:The average bleeding volume during operation was only 18 mL, except that the bleeding volume of only one patient, who suffered from the sacroiliacjoint injury and received open reduction and internal fixation, was up to 300 mL. The total number of screws used in the operation was 42, among which 24 were screws for acetabular anterior column fracture and 18 for posterior column fracture. Al screws were implanted once precisely. The average time of internal fixation was 59 minutes, and the mean time for fluoroscopy was 39 seconds. The 31 patients were pain-free one week after the operation and no complication (infection, vascular nerve injury or implant breakage) was noted post-operatively. When the fol ow-up ended, radiography revealed fracture union with satisfactory screw fixation (no screw breakage or loosening). According to Matta functional scoring, results were excellent in 23 cases, good in 8 cases, with an excellent and good rate of 100%. According to Majeed functional scoring, the results were excellent in 22 cases, good in 6 cases and average in 3 cases, with an excellent and good rate of 90%. These results indicated that ISO-C3D computerized navigational system can supply stable internal fixation without an increase of complication.