Takeba Jun, Umakoshi Kensuke, Kikuchi Satoshi, Matsumoto Hironori, Annen Suguru, Moriyama Naoki, Nakabayashi Yuki, Sato Norio, Aibiki Mayuki
Department of Emergency Medicine and Critical Care, Ehime University, Shitsukawa, Toon, Ehime, 791-0295, Japan.
Department of Aeromedical Services for Emergency and Trauma Care, Ehime University, Shitsukawa, Toon, Ehime, 791-0295, Japan.
Eur J Orthop Surg Traumatol. 2018 Apr;28(3):431-438. doi: 10.1007/s00590-017-2075-9. Epub 2017 Nov 9.
Screw fixation for unstable pelvic ring fractures is generally performed using the C-arm. However, some studies reported erroneous piercing with screws, nerve injuries, and vessel injuries. Recent studies have reported the efficacy of screw fixations using navigation systems. The purpose of this retrospective study was to investigate the accuracy of screw fixation using the O-arm imaging system and StealthStation navigation system for unstable pelvic ring fractures.
The participants were 10 patients with unstable pelvic ring fractures, who underwent screw fixations using the O-arm StealthStation navigation system (nine cases with iliosacral screw and one case with lateral compression screw). We investigated operation duration, bleeding during operation, the presence of complications during operation, and the presence of cortical bone perforation by the screws based on postoperative CT scan images. We also measured the difference in screw tip positions between intraoperative navigation screen shot images and postoperative CT scan images.
The average operation duration was 71 min, average bleeding was 12 ml, and there were no nerve or vessel injuries during the operation. There was no cortical bone perforation by the screws. The average difference between intraoperative navigation images and postoperative CT images was 2.5 ± 0.9 mm, for all 18 screws used in this study.
Our results suggest that the O-arm StealthStation navigation system provides accurate screw fixation for unstable pelvic ring fractures.
不稳定骨盆环骨折的螺钉固定通常使用C形臂进行。然而，一些研究报告了螺钉误穿、神经损伤和血管损伤的情况。最近的研究报道了使用导航系统进行螺钉固定的疗效。本回顾性研究的目的是探讨使用O形臂成像系统和StealthStation导航系统对不稳定骨盆环骨折进行螺钉固定的准确性。
研究对象为10例不稳定骨盆环骨折患者，他们使用O形臂StealthStation导航系统进行了螺钉固定（9例使用髂骶螺钉，1例使用外侧加压螺钉）。我们根据术后CT扫描图像调查了手术时间、术中出血情况、术中并发症的发生情况以及螺钉是否存在皮质骨穿孔。我们还测量了术中导航屏幕截图图像与术后CT扫描图像之间螺钉尖端位置的差异。
平均手术时间为71分钟，平均出血量为12毫升，术中无神经或血管损伤。螺钉未出现皮质骨穿孔。本研究中使用的所有18枚螺钉，术中导航图像与术后CT图像的平均差异为2.5±0.9毫米。
我们的结果表明，O形臂StealthStation导航系统为不稳定骨盆环骨折提供了准确的螺钉固定。
