Gao Hua, Liu Zhenyu, Wang Gang, Wang Baojun
Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
Int J Gen Med. 2021 Aug 4;14:4145-4153. doi: 10.2147/IJGM.S321005. eCollection 2021.
Due to the metal elasticity of intramedullary nails (IMs) and irregularities of the long bone marrow cavity and other reasons, one of the greatest challenges for surgeons is to position the distal locking screw. Therefore, a novel laser guiding navigation device was designed for the distal locking of femoral IMs. The purpose of this study was to compare the effectiveness of the novel device and freehand technique for distal locking of IMs in the femoral model.
The laser guiding navigation device (laser group) and freehand technique (freehand group) were used in the distal locking of the IMs in the femoral model. All operations were performed by surgeons of the same level. The differences between the two groups were compared in terms of operative time, radiation exposure time, first success rate, deviation angle between ideal trajectory and actual trajectory, and learning curve.
The distal locking of the IMs in the femoral model was performed 40 times in each group. The results showed that the laser group was better than the freehand group in terms of operative time (345±165 VS 212±105 seconds, ), radiation exposure time (164±57 VS 41±15 seconds, ) and first successrate ( =21.36, <0.001). Compared with the freehand group, the actual trajectory of the laser group was closer to the ideal trajectory in coronal and horizontal planes. Furthermore, the learning curve time of the laser group was shorter.
Compared with traditional freehand technique, the novel laser guiding navigation device can shorten the operative time and reduce radiation exposure invitro. In addition, it is easy to master with more accuracy and a higher first success rate in vitro.
由于髓内钉的金属弹性、长骨髓腔不规则等原因，外科医生面临的最大挑战之一是远端锁定螺钉的定位。因此，设计了一种新型激光引导导航装置用于股骨髓内钉的远端锁定。本研究的目的是比较新型装置和徒手技术在股骨模型中髓内钉远端锁定的有效性。
在股骨模型中使用激光引导导航装置（激光组）和徒手技术（徒手组）进行髓内钉的远端锁定。所有手术均由同一水平的外科医生进行。比较两组在手术时间、辐射暴露时间、首次成功率、理想轨迹与实际轨迹之间的偏差角度以及学习曲线方面的差异。
每组在股骨模型中进行髓内钉远端锁定40次。结果显示，激光组在手术时间（345±165对212±105秒）、辐射暴露时间（164±57对41±15秒）和首次成功率（χ²=21.36，P<0.001）方面均优于徒手组。与徒手组相比，激光组的实际轨迹在冠状面和水平面更接近理想轨迹。此外，激光组的学习曲线时间更短。
与传统徒手技术相比，新型激光引导导航装置可缩短体外手术时间并减少辐射暴露。此外，它在体外易于掌握，具有更高的准确性和首次成功率。
