电磁定位系统在肱骨干髓内钉中的应用可减少手术时间，提高远端锁定的准确性。

Reduced Surgical Time and Higher Accuracy of Distal Locking with the Electromagnetic Targeting System in Humeral Shaft Intramedullary Nailing.

机构信息

Department of Orthopaedic Traumatology, Trauma Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Orthop Surg. 2020 Oct;12(5):1413-1420. doi: 10.1111/os.12785. Epub 2020 Sep 6.

DOI:10.1111/os.12785

PMID:32893489

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7670153/

Abstract

OBJECTIVE

To evaluate the efficacy of the electromagnetic distal targeting system in the treatment of humeral shaft fractures.

METHODS

From January 2012 to December 2018, we retrospectively reviewed 60 patients with humeral shaft fractures treated by intramedullary nailing. Among 60 cases, 41 were men and 19 were women. The average age at surgery was 48.5 years (range, 21-81 years). We performed the same surgical procedure for all patients. According to the different distal locking technique used, all patients were divided into two groups. The standard fluoroscopic freehand technique was used for Group FH, while the electromagnetic real-time targeting technique was used for Group EM. All procedures were performed by two senior surgeons. Overall surgical time, cases of complications, failure of distal locking, union time, and shoulder function assessment were recorded intraoperatively and during follow-up.

RESULTS

Twenty-seven patients in Group FH and 33 patients in Group EM met the inclusion criteria. No significant difference was found in the demographic data of the two groups. The mean surgical time was 76.48 ± 10.73 min in Group FH and 65.61 ± 8.91 min in Group EM (P < 0.05), showing significant difference. Seven failures occurred in Group FH and two failures occurred in Group EM (P < 0.05). No relevant complications were noted. The average union time was 3.37 ± 0.49 months in Group FH and 3.39 ± 0.50 months in Group EM (P = 0.855). The mean follow-up was 14.30 ± 2.28 months in Group FH and 15.27 ± 2.83 months in Group EM (P = 0.153). The disabilities of the arm, shoulder and hand score (DASH) score, the range of motion (checked with the constant score), and the degree of functionality were, respectively, 21.52 ± 3.23, 27.04 ± 1.84, and 81.31% ± 3.88% in Group FH and 19.09 ± 2.40, 26.18 ± 1.70, and 77.97% ± 3.91% in Group EM (P = 0.233, 0.971, and 0.607).

CONCLUSION

The electromagnetic real-time targeting system reduced surgical time and improved accuracy, and there was no radiation exposure in the distal locking procedure for humeral shaft fractures.

摘要

目的

评估电磁远距靶向系统在治疗肱骨干骨折中的疗效。

方法

回顾性分析 2012 年 1 月至 2018 年 12 月采用髓内钉治疗的 60 例肱骨干骨折患者的临床资料。60 例患者中，男 41 例，女 19 例；年龄 21～81 岁，平均 48.5 岁。所有患者均采用相同的手术方法。根据不同的远端锁定技术，将所有患者分为两组。FH 组采用标准透视徒手技术，EM 组采用电磁实时靶向技术。所有手术均由两位资深外科医生完成。术中及随访时记录手术总时间、并发症发生情况、远端锁定失败、愈合时间和肩关节功能评估。

结果

FH 组 27 例，EM 组 33 例符合纳入标准。两组患者的一般资料比较，差异无统计学意义（P＞0.05）。FH 组手术时间为 76.48±10.73 min，EM 组为 65.61±8.91 min（P＜0.05），差异有统计学意义。FH 组发生 7 例远端锁定失败，EM 组发生 2 例远端锁定失败（P＜0.05）。两组均未发生相关并发症。FH 组愈合时间为 3.37±0.49 个月，EM 组为 3.39±0.50 个月（P=0.855）。FH 组平均随访时间为 14.30±2.28 个月，EM 组为 15.27±2.83 个月（P=0.153）。FH 组和 EM 组的肩关节和手功能障碍（DASH）评分分别为 21.52±3.23 和 19.09±2.40，肩关节活动度（Constant 评分）分别为 27.04±1.84 和 26.18±1.70，肩关节功能分别为 81.31%±3.88%和 77.97%±3.91%（P=0.233，0.971，0.607）。