髋关节置换手术计算机辅助髓腔锉切削导向系统

目的介绍一种髋关节置换手术计算机辅助髓腔锉切削导向方法，协助医生术中确定适当的髓腔锉切削导路，有效降低髋关节置换手术中骨折等并发症的发生。方法首先将探棒插入患者股骨腔，将探棒的中心线作为一条切削患者股骨腔松质骨的参考导路。接着将髓腔锉放置入患者股骨腔，将连接在髓腔锉上的打拔器导杆中心线作为髓腔锉当前切削导路。最后，根据在计算机显示屏上显示的髓腔锉切削参考导路以及当前切削导路的差异情况，调整髓腔锉切削的方向和位置。采用本研究的一个样机，验证了计算机显示的参考导路与当前导路的差异情况是否与实际情况相符。结果计算机显示出的参考导路与当前导路的差异情况与实际情况相符。结论理论分析与实验结果表明，本方法能够协助手术医生确定出适当的髓腔锉切削参考导路，使髋关节置换手术更加方便可靠。采用计算机辅助髓腔锉切削导向方法能降低术中股骨骨折的风险，提高股骨柄假体植入的成功率。

Computer aided intramedullary broacher guiding system for hip joint replacement

Objective To introduce a computer aided navigation method of guiding intramedullary broacher in a hip joint replacement operation. The method can help surgeons to determine a proper intramedullary broacher cutting path in operations and reduce the risk of some complications, such as bone fracture. Methods First a probe was inserted into a patient＇ s marrow cavity and the center line of the probe was chosen as the reference path for cutting the patient＇ s cancellous bone. Then we placed the intramedullary broacher into the patient＇ s marrow cavity and took the center line of the extractor rod, which connected with the intramedullary broacher, as the current cutting path of the intramedullary broacher. At last, we adjusted the intramedullary broacher according to the reference and current cutting paths, which were shown on a computer screen. By using a prototype of this navigator, whether the difference between the reference and actual paths on a computer display consistent with the actual situation or not was verified. Results The difference between the reference and actual paths on a computer display was consistent with the actual situation. Conclusions Theoretical analysis and the experimental result show that a surgeon can determine a proper intramedullary broachercutting path by using the method introduced in this paper. This method can make hip joint replacement operations more convenient and reliable, reduce the risk of bone fracture in operations and improve the success of implanting hip stem prostheses.