本文選題：計(jì)算機(jī)輔助骨科手術(shù)　切入點(diǎn)：股骨頸骨折　出處：《中國修復(fù)重建外科雜志》2017年03期

【摘要】：目的探討基于誤差糾正算法的計(jì)算機(jī)輔助股骨頸骨折空心螺釘內(nèi)固定系統(tǒng)的臨床應(yīng)用價(jià)值。方法回顧性分析2014年1月—2015年10月,采用基于誤差糾正算法的計(jì)算機(jī)輔助股骨頸骨折空心螺釘內(nèi)固定系統(tǒng)完成股骨頸骨折閉合復(fù)位空心螺釘內(nèi)固定術(shù)的20例患者臨床資料(試驗(yàn)組),并與同期采用傳統(tǒng)徒手植釘法完成手術(shù)的36例患者(對照組)進(jìn)行比較。兩組患者性別、年齡、致傷原因、骨折側(cè)別、骨折類型、受傷至手術(shù)時(shí)間等一般資料比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。比較兩組手術(shù)時(shí)間、術(shù)中出血量、術(shù)中透視次數(shù)、術(shù)中鉆入導(dǎo)針次數(shù)、骨折愈合時(shí)間、骨折愈合率以及髖關(guān)節(jié)Harris評分。結(jié)果兩組術(shù)后切口均Ⅰ期愈合,無神經(jīng)、血管損傷等并發(fā)癥發(fā)生。試驗(yàn)組手術(shù)時(shí)間較對照組顯著延長(t=2.290,P=0.026),但術(shù)中出血量、術(shù)中透視次數(shù)、術(shù)中鉆入導(dǎo)針次數(shù)均較對照組顯著降低,比較差異有統(tǒng)計(jì)學(xué)意義(t= 10.650,P=0.000;t=18.320,P=0.000;t= 16.625,P=0.000)。所有患者術(shù)后均獲隨訪,隨訪時(shí)間12~18個(gè)月,平均14.7個(gè)月。X線片復(fù)查示,兩組骨折均愈合,且骨折愈合時(shí)間比較差異無統(tǒng)計(jì)學(xué)意義(t=0.208,P=0.836);隨訪期間無股骨頭缺血性壞死等并發(fā)癥發(fā)生。末次隨訪時(shí),試驗(yàn)組髖關(guān)節(jié)Harris評分為(87.05±3.12)分,對照組為(86.78±2.83)分,比較差異無統(tǒng)計(jì)學(xué)意義(t=0.333,P=0.741)。結(jié)論與傳統(tǒng)徒手植釘手術(shù)相比,采用基于誤差糾正算法的計(jì)算機(jī)輔助股骨頸骨折空心螺釘內(nèi)固定系統(tǒng)輔助手術(shù)在減少術(shù)中輻射、減小手術(shù)創(chuàng)傷等方面具有一定優(yōu)勢。
[Abstract]:Objective to explore the clinical application value of computer-aided hollow screw fixation system for femoral neck fracture based on error correction algorithm. Methods retrospective analysis was made from January 2014 to October 2015. Clinical data of 20 cases of closed reduction and Hollow Screw Internal Fixation of femoral neck fractures completed by computer aided Hollow Screw Internal Fixation system based on error Correction algorithm. A comparison was made between 36 patients (control group) who underwent the operation with bare hand nail implantation. Age, cause of injury, fracture side, fracture type, injury to operation time and other general data, the differences were not statistically significant (P 0.05), compared the two groups of operation time, intraoperative blood loss, intraoperative fluoroscopy times, and so on. Results the times of penetration, the time of fracture healing, the rate of fracture healing and the score of Harris of hip joint were obtained. Compared with the control group, the operative time of the experimental group was significantly longer than that of the control group, but the amount of blood loss, the times of fluoroscopy and the times of penetration of the guide needle were significantly lower in the experimental group than in the control group. The difference was statistically significant (t = 10.650 ~ 0.000 ~ 18.320 / t = 16.625 ~ 0.000). All the patients were followed up for 12 ~ 18 months with an average of 14.7 months. The fracture healed in both groups. There was no significant difference in fracture healing time between the two groups. There were no complications such as avascular necrosis of femoral head during the follow-up. The Harris score of hip joint in the trial group was 87.05 鹵3.12 at the last follow-up, and that in the control group was 86.78 鹵2.83). There was no statistical difference between the two groups. Conclusion compared with the traditional bare-hand nail grafting, the computer-aided internal fixation system for femoral neck fractures with hollow screw fixation system based on error correction algorithm can reduce the radiation during operation. It has some advantages in reducing surgical trauma and so on.
【作者單位】： 中國人民解放軍總醫(yī)院骨科;北京航空航天大學(xué)機(jī)器人研究所;
【基金】：全軍醫(yī)學(xué)科研“十二五”計(jì)劃課題資助項(xiàng)目(BWS11J113) 國家高技術(shù)研究發(fā)展計(jì)劃(863)資助項(xiàng)目(2015AA043204、2015AA043201) 中國人民解放軍總醫(yī)院科技創(chuàng)新苗圃基金資助項(xiàng)目(16KMM21)~~
【分類號】：R687.3

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