Division of Orthopaedics, Department of Surgery, St. Michael's Hospital, University of Toronto, ON, Canada.
J Am Acad Orthop Surg. 2010 May;18(5):247-58. doi: 10.5435/00124635-201005000-00001.
Computer-assisted orthopaedic surgery (CAOS) is performed by digitizing the patient's anatomy, combining the images in a computerized system, and integrating the surgical instruments into the digitized image background. This allows the surgeon to navigate the surgical instruments and the bone in an improved, virtual visual environment. CAOS in traumatology is performed with images obtained by fluoroscopy, CT, or three-dimensional fluoroscopy. CAOS is used in basic trauma procedures for preoperative planning, fracture reduction, intramedullary nailing, percutaneous screw or plate fixation, and hardware or shrapnel removal. Potential benefits of CAOS include minimal invasiveness, increased accuracy, and decreased radiation exposure. Limitations include a significant learning curve, increased surgical time, requirements for special setup and equipment handling in the operating room, specialized technical support, and cost. Current evidence shows no advantage with CAOS in trauma cases compared with conventional methods. Prospective randomized trials and clinical outcomes are lacking.
计算机辅助骨科手术(CAOS)通过对患者解剖结构进行数字化,将图像在计算机系统中进行组合,并将手术器械集成到数字化图像背景中来实现。这使得外科医生能够在改进的虚拟视觉环境中导航手术器械和骨骼。创伤学中的 CAOS 使用透视、CT 或三维透视获得的图像来完成。CAOS 用于基本的创伤程序,包括术前规划、骨折复位、髓内钉固定、经皮螺钉或钢板固定以及去除硬件或弹片。CAOS 的潜在益处包括微创性、更高的准确性和减少辐射暴露。局限性包括陡峭的学习曲线、手术时间延长、手术室中特殊设置和设备操作要求、专门的技术支持以及成本。目前的证据表明,CAOS 在创伤病例中与传统方法相比没有优势。缺乏前瞻性随机试验和临床结果。
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