Tsai Kai-Jow, Shen Po-Wen, Hutton William C
Department of Orthopaedic Surgery, Cathay General Hospital, Taipei, Taiwan.
BMC Musculoskelet Disord. 2005 Oct 17;6:51. doi: 10.1186/1471-2474-6-51.
Open methods for removal of femoral interlocking nails involve an incision (up to 10 cm) over the trochanter to find the tip of the nail. The distal locking screws are some times difficult to palpate and an incision (up to about 5 cm) is often needed for exposure. Intra-operative fluoroscopy is often used as an adjunct technique to minimize the surgical wound. However, patients and surgeons are exposed to a radiation hazard. Sonography can provide a real-time and efficient alternative to fluoroscopy.
Sonography of soft tissue has been established to identify a foreign body. A metallic implant has a hyperechoic image; therefore, we can identify the correct position of the screws preoperatively and intraoperatively.
We have developed a technique using sonography and minimal incisions for the removal of a femoral interlocking nail. The proximal wound is 2.5 cm in length and the wound is 0.5 cm in length for each distal locking screw.
The sonography can be used to minimize the length of incision and prevent radiation exposure in the removal of intramedullary femoral nails.
用于取出股骨交锁髓内钉的开放方法需要在大转子上做一个切口（长达10厘米）来找到髓内钉的尖端。有时难以触及远端锁定螺钉，常常需要做一个切口（长达约5厘米）来进行暴露。术中透视常作为辅助技术以尽量减小手术切口。然而，患者和外科医生会面临辐射危害。超声检查可为透视提供一种实时且有效的替代方法。
软组织超声检查已用于识别异物。金属植入物具有高回声图像；因此，我们能够在术前和术中识别螺钉的正确位置。
我们已开发出一种利用超声检查和小切口取出股骨交锁髓内钉的技术。近端切口长度为2.5厘米，每个远端锁定螺钉的切口长度为0.5厘米。
在取出股骨髓内钉时，超声检查可用于尽量缩短切口长度并防止辐射暴露。
