使用荧光透视导航系统（史赛克ADAPT系统）对股骨转子间骨折进行计算机辅助手术的准确性分析
Accuracy analysis of computer-assisted surgery for femoral trochanteric fracture using a fluoroscopic navigation system: Stryker ADAPT system.
作者信息
Takai Hirokazu, Murayama Masatoshi, Kii Sakumo, Mito Daisuke, Hayai Chihiro, Motohashi Satoru, Takahashi Tomoki
机构信息
Department of Orthopaedic Surgery, Kumamoto Kinoh Hospital, Kumamoto, Japan.
Department of Orthopaedic Surgery, Kumamoto Kinoh Hospital, Kumamoto, Japan.
出版信息
Injury. 2018 Jun;49(6):1149-1154. doi: 10.1016/j.injury.2018.03.014. Epub 2018 Mar 19.
PURPOSE
ADAPT is a fluoroscopic computer-assisted surgery system which intraoperatively shows the distance from the tip of the screw to the surface of the femoral head, tip-to-head-surface distance (TSD), and the tip-apex distance (TAD) advocated by Baumgaertner et al. The study evaluated the accuracy of ADAPT.
PATIENTS AND METHODS
A total of 55 patients operated with ADAPT between August 2016 and March 2017 were included as subjects. TSD and TAD were measured postoperatively using computed tomography (CT) and X-rays. The intraclass correlation coefficient (ICC) was checked in advance. The error was defined as the difference between postoperative and intraoperative measurement values of ADAPT. Summary statistics, root mean square errors (RMSEs), and correlations were evaluated.
RESULTS
ICC was 0.94 [95% CI: 0.90-0.96] in TSD and 0.99 [95% CI: 0.98-0.99] in TAD. The error was -0.35 mm (-1.83 mm to 1.12 mm) in TSD and +0.63 mm (-5.65 mm to 4.59 mm) in TAD. RMSE was 0.63 mm in TSD and 1.53 mm in TAD. Pearson's correlation coefficient was 0.79 [95% CI: 0.66-0.87] in TSD and 0.83 [95% CI: 0.72-0.89] in TAD. There were no adverse events with ADAPT use.
CONCLUSION
ADAPT is highly accurate and useful in guiding surgeons in properly positioning the screws.
目的
ADAPT是一种荧光透视计算机辅助手术系统，术中可显示螺钉尖端至股骨头表面的距离，即尖端至股骨头表面距离（TSD），以及Baumgaertner等人所倡导的尖端至顶点距离（TAD）。本研究评估了ADAPT的准确性。
患者与方法
纳入2016年8月至2017年3月间使用ADAPT进行手术的55例患者作为研究对象。术后使用计算机断层扫描（CT）和X射线测量TSD和TAD。预先检查组内相关系数（ICC）。误差定义为ADAPT术后与术中测量值之间的差值。评估汇总统计量、均方根误差（RMSE）和相关性。
结果
TSD的ICC为0.94[95%CI：0.90 - 0.96]，TAD的ICC为0.99[95%CI：0.98 - 0.99]。TSD的误差为-0.35毫米（-1.83毫米至1.12毫米），TAD的误差为+0.63毫米（-5.65毫米至4.59毫米）。TSD的RMSE为0.63毫米，TAD的RMSE为1.53毫米。TSD的Pearson相关系数为0.79[95%CI：0.66 - 0.87]，TAD的Pearson相关系数为0.83[95%CI：0.72 - 0.89]。使用ADAPT未出现不良事件。
结论
ADAPT在指导外科医生正确定位螺钉方面具有高度准确性和实用性。
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