透视导航下髋臼前柱骨折术中参考图像的可靠性研究

目的 探讨透视导航下髋臼前柱骨折术中参考图像的可靠性,为采集并选用可靠性较高、符合术中螺钉置入要求的X线图像提供依据. 方法 采用8个人工骨盆模型,逆行钻人克氏针于髋臼前柱中,共80次,每次按照骨盆正位、入口位、出口位、同侧闭孔斜位和出口-闭孔斜位采集图像,并加以组合,A组:骨盆正位、入口位和出口位;B组:入口位、出口位和闭孔斜位;C组:骨盆正位、入口位、出口位和闭孔斜位;D组:骨盆正位、入口位、出口位和出口-闭孔斜位;E组:骨盆正位、入口位、闭孔斜位和出口-闭孔斜位;F组:骨盆正位、出口位、闭孔斜位和出口-闭孔斜位;G组:入口位、出口位、闭孔斜位和出口-闭孔斜位.分别根据单幅透视图像或图像组合,做出克氏针是否进入髋关节的判断,并明确其与真实位置的一致性. 结果 单幅透视图像符合率比较差异有统计学意义(x<'2>=18.286,P=0.001),其中出口-闭孔斜位符合率最高,为72.50%.图像组合A、B、C、D组之间符合率比较差异有统计学意义(X<'2>=17.891,P=0.001),其中图像组合D组(骨盆正位、出、入口位和出口-闭孔斜位)符合率最高,为85.00%.图像组合C、D、E、F、G组之间符合率比较差异有统计学意义(X<'2>=14.553,P=0.006),其中图像组合D组符合率最高,为85.00%. 结论 透视导航下髋臼前柱骨折术中出口-闭孔斜位片和图像组合骨盆正位、出、入口位和出口-闭孔斜位的可靠性较高.

Reliability of images of the acetabular anterior column fracture in fluoro-navigation

Objective To study the reliability of images of the acetabnlar anterior column fracture in the fluoro-navigatiou so that a reliable collection of images can be selected for the placement of screws in the operation. Methods Eight artificial pelvic models were used. Eighty K wires were drilled in a retrograde manner into the acetabular anterior columns one by one. For each K wire, 5 images were collected at 5 dif-ferent views. These images were grouped in 7 combinations to judge whether the K wire was in the hip joint or the pelvis. Group A: pelvic AP, inlet and outlet views; Group B: inlet, outlet and obturator oblique views;Group C: pelvic AP, inlet, outlet and obturator oblique views; Group D: pelvic AP, inlet, outlet and out-let-obturator oblique views; Group E: pelvic AP, inlet, obturator oblique and outlet-obturator oblique views;Group F: pelvic AP, outlet, obturator oblique and outlet-obturator oblique views; Group G: inlet, outlet, obturator oblique and outlet-obturator oblique views; The reliability was evaluated through comparison with the actual placement of the K wire. Results When comparison was made according to every single image, the coincidence of the outlet-obturator oblique view was 72.50% (Chi-Square Value = 18.286, P = 0.001).When comparison was made between groups A, B, C and D, the coincidence of the images in group D was 85.00% (Chi-Square Value = 17.891, P = 0.001), When comparison was made between groups C, D, E, F and G, the coincidence of the images in group D was 85.00% (Chi-Sqnare Value = 14. 553; P = 0.006).Conclusion The outlet-obturator oblique view and the collection of images (the AP view, inlet view, outlet view and outlet-obturator oblique view) are highly reliable.