Vanderbilt Department of Orthopaedics, Nashville, Tennessee, USA.
J Orthop Trauma. 2009 Oct;23(9):658-62. doi: 10.1097/BOT.0b013e3181b01b46.
The purpose of this study was to evaluate the safety of a distal femoral traction pin subjected to a 1.5-T magnetic resonance image (MRI) with regard to pin migration and implant heating in a cadaveric model.
Deflection angles of various traction pins as well as a Bohler-style Steinmann Pin Tractor Bow (tractor bow) and a Kirschner wire bow subjected to a 1.5-T clinical MRI were measured. Tractions pins were placed into a cadaveric femur and the tractor bow was attached to the most distal pin to simulate distal femoral traction. Temperature and migration were measured after subjecting the cadaveric leg to a "worst-case scenario" MRI sequence for 30 minutes.
All traction pins and bows showed deflection. The Kirschner wire bow showed a hazardous level of deflection and was immediately removed from further testing. The pin temperature changes were not significantly different than the changes in the MRI room temperature and a conduction loop was not seen in the combination pin and tractor bow. There was no significant migration of any pin nor was there objective loosening from pin vibration.
Implant-quality stainless steel traction pins show no signs of adverse heating or pin migration when subjected to 1.5-T MRI clinical scanning. Kirschner bows are highly ferromagnetic and should not be used unless individually tested for safety. Steinmann Pin Tractor Bows that show weak ferromagnetism preliminarily appear safe to use during a 1.5-T MRI and do not produce a conduction loop with excessive heating in a cadaveric model, although further testing is indicated.
本研究旨在评估在尸体模型中,股骨远端牵引针在 1.5T 磁共振成像(MRI)下的安全性,包括针迁移和植入物加热。
测量了各种牵引针、Bohler 式 Steinmann 导针牵引弓(牵引弓)和克氏针弓在 1.5T 临床 MRI 下的偏转角。将牵引针放置到尸体股骨中,并将牵引弓连接到最远端的针上,以模拟股骨远端牵引。在尸体腿上进行 30 分钟的“最坏情况”MRI 序列后,测量温度和迁移。
所有牵引针和弓都发生了偏转角。克氏针弓显示出危险水平的偏转角,并立即停止进一步测试。针的温度变化与 MRI 室温的变化没有显著差异,并且在组合针和牵引弓中没有看到传导回路。没有任何针的明显迁移,也没有因针振动而导致的客观松动。
在进行 1.5T MRI 临床扫描时,植入级不锈钢牵引针没有出现不良加热或针迁移的迹象。克氏针具有很强的铁磁性,除非经过单独测试安全,否则不应使用。初步显示,具有弱铁磁性的 Steinmann 导针牵引弓在 1.5T MRI 期间使用是安全的,并且不会在尸体模型中产生传导回路和过度加热,尽管需要进一步测试。