Külling Fabrice Alexander, Ebneter Lukas, Rempfler Georg Stefan, Zdravkovic Vilijam
Department of Orthopaedics and Traumatology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland.
Swiss Federal Institute of Technology in Zurich (ETH), Zurich, Switzerland.
Eur Spine J. 2018 May;27(5):1172-1177. doi: 10.1007/s00586-017-5341-y. Epub 2017 Oct 24.
To prove that a modified closing mechanism of the rongeur gives better precision compared to the old Kerrison rongeur.
Forty persons from the departments of orthopaedic surgery, urology and neurosurgery (35 orthopaedic, 2 urology and 3 neurosurgery) took part in the study. All participants were asked to punch ten times in a first step with either the old Kerrison rongeur with the scissors-like handle or the modified punch with a new parallel closing mechanism. In a second step, they punched 10 times with the other instrument. Shaft movement in three dimensions was measured with a stereoscopic, contactless, full-field digital image correlation system.
The new rongeur is significantly more precise with less movement in all three dimensions. The mechanical model of the new rongeur shows that the momentum needed to keep the tip at the initial position changes only minimally during the closing act on the new model.
The new rongeur is more precise compared to the old Kerrison model. It is more robust against changes in the direction of the finger forces and may reduce soreness, fatigue and CTS in spine surgeons.
Not applicable: technical study.
证明咬骨钳的改良闭合机制相比老式克里森咬骨钳具有更高的精度。
来自骨科、泌尿外科和神经外科的40人（35名骨科医生、2名泌尿外科医生和3名神经外科医生）参与了该研究。所有参与者首先使用带有剪刀状手柄的老式克里森咬骨钳或具有新型平行闭合机制的改良咬骨钳进行十次冲压操作。第二步，他们使用另一种器械再冲压10次。使用立体、非接触、全场数字图像相关系统测量三个维度上的轴运动。
新型咬骨钳在所有三个维度上的运动更少，精度显著更高。新型咬骨钳的力学模型表明，在新型咬骨钳的闭合过程中，使尖端保持在初始位置所需的动量变化极小。
与老式克里森模型相比，新型咬骨钳更精确。它对手指力方向的变化更具鲁棒性，可能会减轻脊柱外科医生的酸痛、疲劳和腕管综合征。
不适用：技术研究。
