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导航引导下微创经皮置入骨盆螺钉治疗侧方压缩型骨盆环损伤的螺钉视角模型:1例病例报告

A screw view model of navigation guided minimal invasive percutaneous pelvic screws insertion for lateral compression pelvic ring injuries: A case report.

作者信息

Yuan Bao-Ming, Huang Ge, Zheng Shuang, Yu Tong, Zhao Jian-Wu

机构信息

Department of Orthopaedics.

Department of Radiology, The Second Hospital of Jilin University, Changchun, Jilin Province, China.

出版信息

Medicine (Baltimore). 2020 Oct 2;99(40):e21755. doi: 10.1097/MD.0000000000021755.

Abstract

RATIONALE

The objective of the present study was to evaluate the accuracy, effectiveness, and safety of screw view model of navigation (SVMN) guided minimal invasive percutaneous pelvic screws (PPSs) insertion for lateral compression pelvic ring injuries (PRI).

PATIENT CONCERNS

A female patient experienced a high falling injury, and presented with pain, swelling, deformity, and movement limitation of the left hip for 3 hours.

DIAGNOSES

She was diagnosed with pelvic fractures, left iliac fracture, left pubic branch fracture, left ischial branch fracture, and lumbar transverse process fracture.

INTERVENTIONS

We used a SVMN technique to guide PPSs insertion, including a percutaneous anterior inferior iliac spine screw, a percutaneous iliac screw (PIS), and a percutaneous sacroiliac screw (PSIS).

OUTCOMES

In total, 3 PPSs were inserted and all were presented with excellent position postoperatively. The designing time of all screws was 11.7 minutes, the time of all guide needles insertion was 18.1 minutes, the time of all screws insertion was 32.8 minutes, blood loss was 21 mL, and the time of radiation exposure lasted 7.2 minutes. Moreover, surgical complications, including neurovascular compromise, wound infection, fracture nonunion, and screw loosening, were not observed during the 12 months follow up visit.

LESSONS

SVMN technique guided PPSs insertion is an effective and safety approach for the treatment of PRI in selected patients. Besides, it is necessary for surgeons to master the rationale of computer navigation, to familiar with the anatomy of pelvis and to select suitable patients.

摘要

原理

本研究的目的是评估导航螺钉视图模型(SVMN)引导下微创经皮插入骨盆螺钉(PPS)治疗侧方压缩型骨盆环损伤(PRI)的准确性、有效性和安全性。

患者情况

一名女性患者高处坠落受伤,左髋部疼痛、肿胀、畸形及活动受限3小时。

诊断

诊断为骨盆骨折、左髂骨骨折、左耻骨支骨折、左坐骨支骨折及腰椎横突骨折。

干预措施

我们采用SVMN技术引导插入PPS,包括经皮髂前下棘螺钉、经皮髂骨螺钉(PIS)和经皮骶髂螺钉(PSIS)。

结果

共插入3枚PPS,术后位置均良好。所有螺钉设计时间为11.7分钟,所有导针插入时间为18.1分钟,所有螺钉插入时间为32.8分钟,出血量为21毫升,辐射暴露时间为7.2分钟。此外,在12个月的随访中未观察到手术并发症,包括神经血管损伤、伤口感染、骨折不愈合和螺钉松动。

经验教训

SVMN技术引导下PPS插入是治疗特定患者PRI的一种有效且安全的方法。此外,外科医生有必要掌握计算机导航原理,熟悉骨盆解剖结构并选择合适的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d94a/7535558/1c13d4d661c3/medi-99-e21755-g002.jpg

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