Liu Lin, Xu Xian, Li Xu, Wu Wei, Cai Junfeng, Lu Qingyou
Department of Trauma Surgery and Joint Surgery, East Hospital Affiliated to Tongji University, Shanghai, China (mainland).
Med Sci Monit. 2017 Jun 12;23:2871-2878. doi: 10.12659/msm.902261.
BACKGROUND This prospective study aimed to compare clinical effects of intramedullary nailing guided by digital and conventional technologies in treatment of tibial fractures. MATERIAL AND METHODS Thirty-two patients (mean age 43 years, 18 males and 14 females) who were treated for tibial fractures from October 2010 to October 2012 were enrolled. They were sequentially randomized to receive intramedullary nailing guided by either digital technology (digital group, n=16) or conventional technology (conventional group, n=16). The operation time, fluoroscopy times, fracture healing time, distance between the actual and planned insertion point, postoperative lower limb alignment, and functional recovery were recorded for all patients. RESULTS The mean operation time in the digital group was 43.1±6.2 min compared with 48.7±8.3 min for the conventional technology (P=0.039). The fluoroscopy times and distance between the actual and planned insertion point were significantly lower in the digital group than in the conventional group (both P<0.001). The accuracy rate of the insertion point was 99.12% by digital technology. No difference was found in fracture healing time and good postoperative lower limb alignment between the digital and conventional groups (P=0.083 and P=0.310), as well as the effective rate (100% vs. 87.50%, P=0.144). CONCLUSIONS Intramedullary nailing guided by digital technology has many advantages in treatment of tibial fractures compared to conventional technology, including shorter operation time, reduced fluoroscopy times, and decreased distance between the actual and planned insertion point of the intramedullary nail.
背景 本前瞻性研究旨在比较数字化技术与传统技术引导下的髓内钉固定术治疗胫骨骨折的临床效果。
材料与方法 选取2010年10月至2012年10月期间接受胫骨骨折治疗的32例患者(平均年龄43岁,男18例,女14例)。将他们依次随机分为接受数字化技术引导下髓内钉固定术的数字化组(n = 16)和接受传统技术引导下髓内钉固定术的传统组(n = 16)。记录所有患者的手术时间、透视次数、骨折愈合时间、实际与计划插入点之间的距离、术后下肢对线情况及功能恢复情况。
结果 数字化组的平均手术时间为43.1±6.2分钟,而传统技术组为48.7±8.3分钟(P = 0.039)。数字化组的透视次数及实际与计划插入点之间的距离显著低于传统组(均P<0.001)。数字化技术的插入点准确率为99.12%。数字化组与传统组在骨折愈合时间、术后下肢良好对线情况以及有效率方面(100%对87.50%,P = 0.144)均未发现差异(P = 0.083和P = 0.310)。
结论 与传统技术相比,数字化技术引导下的髓内钉固定术在治疗胫骨骨折方面具有许多优势,包括手术时间更短、透视次数减少以及髓内钉实际与计划插入点之间的距离减小。