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首页> 外文期刊>Proceedings of the Institution of Mechanical Engineers, Part H. Journal of Engineering in Medicine >Evaluation of a new computer-assisted surgical planning and navigation system based on two-dimensional fluoroscopy for insertion of a proximal femoral nail: an experimental study
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Evaluation of a new computer-assisted surgical planning and navigation system based on two-dimensional fluoroscopy for insertion of a proximal femoral nail: an experimental study

机译：基于二维荧光透视的新型计算机辅助手术计划和导航系统评估股骨近端指甲插入的实验研究

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摘要

Pertrochanteric femoral fractures are common and intramedullary nailing is an accepted method for their surgical treatment. Accurate placement of the implant is essential to ensure fixation. The conventional technique can require multiple guide wire passes, and relies heavily on fluoroscopy. A computer-assisted planning and navigation system based on twodimensional fluoroscopy for guide wire placement in the femoral neck has been developed, in order to perform intramedullary pertrochanteric fracture fixation using the proximal femoral nail (PFNA?). The planning process was supported by a 'zero-dose C-arm navigation' system. The PFNA was inserted into 12, intact, femoral sawbones guided by the computer-based navigation, and into 12, intact, femoral sawbones using a conventional fluoroscopic-assisted technique. Guide wire and subsequent blade placement in the femoral neck was evaluated. The computerassisted technique achieved a significant decrease in the number of required fluoroscopic images and in the number of guide wire passes. The obtained average blade placement accuracy in the femoral neck was equivalent to the conventional technique. The operation time was significantly longer in the navigation-assisted group. The addition of computer-assisted planning and surgical guidance to the intramedullary nailing of pertrochanteric femoral fractures offers a number of clinical benefits based on the results of this sawbone study. Further studies including fractured sawbones and cadaver models with extension of the navigation process to all steps of PFNA introduction and with the goal of reducing operation time are indispensable before integration of this navigation system into clinical practice.
机译：股骨转子周围骨折很常见，髓内钉固定是手术治疗的公认方法。植入物的正确放置对于确保固定至关重要。常规技术可能需要多次导丝通过，并且严重依赖于荧光检查。为了使用股骨近端钉（PFNA？）进行股骨粗隆间骨折内固定，已经开发了一种基于二维荧光透视的计算机辅助计划和导航系统，用于将导丝放置在股骨颈中。 “零剂量C臂导航”系统支持了计划过程。 PFNA通过传统的荧光镜辅助技术被插入到12条完整的股骨锯骨中，并插入12条完整的股骨锯骨中。评估导丝和随后在股骨颈中的刀片放置。计算机辅助技术显着减少了所需的透视图像的数量和导丝通过的数量。在股骨颈中获得的平均刀片放置精度与常规技术相同。导航辅助组的手术时间明显更长。根据该锯骨研究的结果，在股骨粗隆间股骨骨折的髓内钉内添加计算机辅助计划和手术指导可带来许多临床益处。在将导航系统集成到临床实践之前，必须进行进一步的研究，包括将断裂的锯骨和尸体模型扩展到PFNA引入的所有步骤，并缩短操作时间。

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