CAJ | 학술논문

目的比较ISO-C3D计算机辅助导航与普通C形臂X线机透视下经皮骶髂螺钉治疗骨盆后环损伤的效果. 方法回顾性分析2006年6月-2012年1月采用经皮骶髂螺钉微创治疗骨盆后环损伤患者65例,其中男37例,女28例；年龄18 ～ 63岁,平均35.9岁.根据骨盆骨折Tile分型:B1型10例,B2型15例,B3型9例,C1型18例,C2型13例.根据术中透视方式的不同,将患者分为ISO-C3D计算机辅助导航组(A组,35例),C形臂X线机透视组(B组,30例).记录术中透视时间、每枚螺钉置入时间、骨折复位满意率、骨折愈合时间及术后功能优良率等方面的结果. 结果 65例患者共置入空心螺钉80枚,A组平均透视时间及置人每枚螺钉平均耗时均低于B组(P ＜0.01).两组骨折复位满意程度的差异无统计学意义.所有患者无感染、血管神经损伤等并发症发生.65例患者均获得随访,时间6 ～ 24个月(平均12.7个月),术后6个月两组功能恢复差异无统计学意义.两组骨折均愈合,无延迟愈合或不愈合. 结论计算机辅助导航手术与普通X线透视比较,减少了术者X线暴露时间,提高了骶髂螺钉置入准确率.
목적 비교ISO-C3D계산궤보조도항여보통C형비X선궤투시하경피저가라정치료골분후배손상적효과. 방법 회고성분석2006년6월-2012년1월채용경피저가라정미창치료골분후배손상환자65례,기중남37례,녀28례；년령18 ～ 63세,평균35.9세.근거골분골절Tile분형:B1형10례,B2형15례,B3형9례,C1형18례,C2형13례.근거술중투시방식적불동,장환자분위ISO-C3D계산궤보조도항조(A조,35례),C형비X선궤투시조(B조,30례).기록술중투시시간、매매라정치입시간、골절복위만의솔、골절유합시간급술후공능우량솔등방면적결과. 결과 65례환자공치입공심라정80매,A조평균투시시간급치인매매라정평균모시균저우B조(P ＜0.01).량조골절복위만의정도적차이무통계학의의.소유환자무감염、혈관신경손상등병발증발생.65례환자균획득수방,시간6 ～ 24개월(평균12.7개월),술후6개월량조공능회복차이무통계학의의.량조골절균유합,무연지유합혹불유합. 결론 계산궤보조도항수술여보통X선투시비교,감소료술자X선폭로시간,제고료저가라정치입준학솔.
Objective To compare the effect of ISO-C3D navigation and conventional C-arm fluoroscopy in iliosacral screws insertion for treatment of posterior pelvic ring injuries.Methods Sixty-five patients with posterior pelvic ring injuries managed by minimally invasive percutaneous iliosacral screws from June 2006 to January 2012 were reviewed.There were 37 males and 28 females,at age range of 18-63 years (mean 35.9 years).Pelvic fracture classification based on Tile system was type B1 in 10 cases,type B2 in 15,type B3 in nine,type C1 in 18 and type C2 in 13.Patients were divided into ISO-C3D navigation group (Group A,n =35) and C-arm fluoroscopy group (Group B,n =30) according to the difference in intraoperative fluoroscopy methods.Intraoperative fluoroscopy time,time cost in inserting a screw,patient satisfaction rate for bone reduction,bone union time and excellent-good rate of postoperative function were recorded.Results Eighty cannulated screws were inserted for the 65 patients.Average fluoroscopy time and time cost in inserting a screw were shorter in Group A than in Group B (P ＜0.01),but there was no statistical difference between the two gronps in patient satisfaction rate for bone reduction.No patient presented with infection,vascular nerve injury or other complications.Follow-up was 6-24 months (mean 12.7 months) for all the patients.Functional recovery showed no statistical difference between the two groups at postoperative 6 months.All fractures were healed and no delayed union or nonunion happened.Conclusion As compared with conventional C-arm fluoroscopy,computer-navigated surgery can reduce fluoroscopy time and improve screw insertion accuracy.