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使用骨内运输钉治疗节段性骨缺损的技术考量

Technical considerations for the management of segmental osseous defects with an internal bone transport nail.

作者信息

Zuckerman Lee M, Scolaro John A, Gardner Matthew P, Kern Thomas, Lanz Philipp, Quinnan Stephen M, Watson J Tracy, Rölfing Jan Duedal

机构信息

Division of Orthopaedic Surgery, City of Hope National Medical Center, Duarte, CA, USA.

Department of Orthopaedic Surgery, University of California Irvine School of Medicine, Irvine, CA, USA.

出版信息

Expert Rev Med Devices. 2022 Mar;19(3):203-211. doi: 10.1080/17434440.2022.2054336. Epub 2022 Mar 17.

Abstract

INTRODUCTION

Traditionally, distraction osteogenesis has been accomplished with an external fixator. All internal transport utilizing magnetic intramedullary nails is a newer technique for bone reconstruction. The Precice Bone Transport Nail is a new implant that allows for noninvasive transport via a magnetically driven motor.

AREAS COVERED

This report describes the function of the Bone Transport Nail along with the technical considerations on how to successfully manage bone defects with this new technology. Appropriate use of the nail, preoperative planning, intraoperative considerations, and postoperative management are discussed in detail.

EXPERT OPINION

The Precice Bone Transport Nail utilizes the technology of the original Precice nail to provide an all-internal option for reconstruction of intercalary defects. This obviates the need for an additional plate with a standard Precice nail when performing bone transport and allows for a less invasive option that decreases operating room time. It provides a more cosmetic result than external fixation and avoids the risks of pin tract infection. Preoperative planning is essential to appropriate execution of the operative procedure and to perform a successful transport. A thorough understanding of the nail design and limitations are a prerequisite as this implant is significantly different from a standard intramedullary nail.

摘要

引言

传统上,牵张成骨是通过外固定器完成的。所有利用磁性髓内钉的内部骨段转移是一种用于骨重建的新技术。Precice骨段转移钉是一种新型植入物,可通过磁驱动电机实现无创骨段转移。

涵盖领域

本报告描述了骨段转移钉的功能以及如何使用这项新技术成功处理骨缺损的技术要点。详细讨论了该钉的正确使用、术前规划、术中注意事项及术后管理。

专家观点

Precice骨段转移钉利用原始Precice钉的技术,为节段性骨缺损的重建提供了一种全内置的选择。这消除了在进行骨段转移时使用标准Precice钉时额外使用钢板的需要,并提供了一种侵入性较小的选择,从而减少了手术时间。与外固定相比,它的外观效果更好,且避免了针道感染的风险。术前规划对于正确实施手术和成功进行骨段转移至关重要。由于这种植入物与标准髓内钉有显著不同,因此对钉的设计和局限性有透彻的了解是先决条件。

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