He Dong-Dong, Deng Chao-Yang, He Xiao-Yu, Lyu Xin, Yang Zhao-Hui, Zhao Lei, Yin Yun-Sheng
The Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China.
Zhongguo Gu Shang. 2022 Apr 25;35(4):317-22. doi: 10.12200/j.issn.1003-0034.2022.04.003.
To investigate the effect of internal external fixator assisted O-arm navigation imaging in the treatment of unstable pelvic fractures.
From May 2019 to November 2019, 15 patients with unstable pelvic fractures were treated by intraoperative O-arm navigation imaging using INFIX technology. There were 6 males and 9 females. The age ranged from 24 to 66 years old. The course of disease ranged from 2 to 14 days. According to Tile classification, there were 1 case of B1 type, 8 cases of B2 type, 3 cases of C1 type, and 3 cases of C2 type. According to Young-Burgess classification, there were 8 cases of LC, 1 case of APC, 4 cases of VS, 2 cases of CM. Preoperative routine pelvic anteroposterior film, entrance position, exit position and pelvic CT three-dimensional reconstruction were performed. Intraoperative O-arm navigation system three-dimensional reconstruction and triplane scanning imaging were used to evaluate the effect of intraoperative reduction. The anterior pelvic ring was fixed with internal external fixator, and the posterior ring was fixed with sacroiliac screw, plate screw or lumbar iliac screw. The operation time, intraoperative bleeding and nail placement were observed and recorded. The quality of fracture reduction was evaluated by Matta standard, and the postoperative function was evaluated by Majeed function score.
Wound healing was good in all patients without vascular, nerve and local irritation complications. All the 15 patients were followed up for 10 to 16 months. The fracture reduction was evaluated according to the Matta scoring standard, 9 cases were excellent results, 5 cases were good, and 1 case was medium. The Majeed functional score was 0 to 95 points.
The built-in external fixator assisted O-arm navigation imaging system in the treatment of unstable pelvic fractures. The reduction effect is evaluated in advance, the operation time is shortened, and the accuracy of internal fixation is improved. The operation is simple, safe and less bleeding. The operation is in line with the principles of minimally invasive medical treatment and precision medical treatment in orthopedics, which is conducive to the recovery of patients' postoperative function and rapid recovery.
探讨内外固定器辅助O型臂导航成像在不稳定骨盆骨折治疗中的作用。
2019年5月至2019年11月，对15例不稳定骨盆骨折患者采用术中O型臂导航成像技术，运用INFIX技术进行治疗。其中男性6例，女性9例。年龄24～66岁。病程2～14天。按Tile分类：B1型1例，B2型8例，C1型3例，C2型3例。按Young-Burgess分类：LC型8例，APC型1例，VS型4例，CM型2例。术前进行骨盆常规正位片、入口位、出口位及骨盆CT三维重建。术中采用O型臂导航系统三维重建及三平面扫描成像评估术中复位效果。骨盆前环采用内外固定器固定，后环采用骶髂螺钉、钢板螺钉或腰髂螺钉固定。观察并记录手术时间、术中出血量及置钉情况。采用Matta标准评估骨折复位质量，采用Majeed功能评分评估术后功能。
所有患者伤口愈合良好，无血管、神经及局部刺激并发症。15例患者均获随访，时间10～16个月。按Matta评分标准评估骨折复位情况，优9例，良5例，中1例。Majeed功能评分为0～95分。
内外固定器辅助O型臂导航成像系统用于不稳定骨盆骨折的治疗，可提前评估复位效果，缩短手术时间，提高内固定准确性，手术操作简单、安全、出血少，符合骨科微创医疗及精准医疗原则，有利于患者术后功能恢复及快速康复。
