Aylott Caspar E W, Hassan Kamran, McNally Donal, Webb John K
Bristol Royal Infirmary, 2 Grove Road, Coombe Dingle, Bristol, UK.
Eur Spine J. 2006 Dec;15(12):1853-7. doi: 10.1007/s00586-006-0113-0. Epub 2006 Jun 28.
This is a case report and laboratory-based biomechanics study. The objective is to report the first case of Titanium rod embolisation during scoliosis surgery into the Pulmonary artery. To investigate the potential of an unconstrained cut Titanium rod fragment to cause wounding with reference to recognised weapons. Embolisation of a foreign body to the heart is rare. Bullet embolisation to the heart and lungs is infrequently reported in the last 80 years. Iatrogenic cases of foreign body embolisation are very rare. Fifty 1-2 cm segments of Titanium rod were cut in an unconstrained manner and a novel method was used to calculate velocity. A high-speed camera (6,000 frames/s) was used to further measure velocity and study projectile motion. The wounding potential was investigated using lambs liver, high-speed photography and local dissection. Rod velocities were measured in excess of 23 m s(-1). Rods were seen to tumble end-over-end with a maximum speed of 560 revolutions/s. The maximum kinetic energy was 0.61 J which is approximately 2% that of a crossbow. This is sufficient to cause significant liver damage. The degree of surface damage and internal disruption was influenced by the orientation of the rod fragment at impact. An unconstrained cut segment of a Titanium rod has a significant potential to wound. Precautions should be taken to avoid this potentially disastrous but preventable complication.
这是一篇病例报告及基于实验室的生物力学研究。目的是报告脊柱侧弯手术期间钛棒栓塞至肺动脉的首例病例。参照公认的武器来研究未受约束切割的钛棒碎片造成创伤的可能性。异物栓塞至心脏的情况罕见。在过去80年中，子弹栓塞至心脏和肺部的报道很少。医源性异物栓塞病例非常罕见。以不受约束的方式切割了50段1 - 2厘米长的钛棒，并采用一种新方法来计算速度。使用高速摄像机（6000帧/秒）进一步测量速度并研究抛射体运动。使用羊肝、高速摄影和局部解剖来研究致伤潜力。测得钛棒速度超过23米/秒。可见钛棒以端对端翻滚的方式运动，最大转速为560转/秒。最大动能为0.61焦耳，约为弩动能的2%。这足以造成严重的肝脏损伤。表面损伤程度和内部破坏受棒碎片撞击时的方向影响。未受约束切割的钛棒段有很大的致伤潜力。应采取预防措施以避免这种潜在灾难性但可预防的并发症。
