Electromagnetic Navigation Cross-locking Intramedullary Nail Technology For Treatment Of Femoral Shaft Fracture

Objective:This study, aimed to retrospectively compare the magnetic navigation f or distal locking ofintramedullary nail and unarmed Lock for the treatment of femor al shaft fracture effect, toverifythe magnetic navigationtecnology, convenience, accurac y, safety. For further guidance department of orthopedics physicians in the treatment o f femoral shaft fracture, select reasonable operation scheme forreference.2012 July -201 4 February method, Department of orthopedics, the First Affiliated Hospital of Xinjia ng Medical University from the center of the 96 cases of femoral shaft fracture patien ts (patients meet the following criteria:age over 16 years old and under 60 years old with intramedullary nails operation indications of the patients), retrospective analysi s. Causes of injury in 96 patients:44 cases, traffic accident injury in high fall injury in 22 cases, falls in 14 cases, crush injury in 8 cases, other injury in 6 cases.80 cas es were male,16 were female;age 16-52 year old, average 38.3 years old. Open frac ture in 6 cases, all Gustilo I injury;closed fracture in 90 cases. Located in the proxim al femoral fractures in 34 cases,48 cases of middle, lower segment in 14 cases. Acc ording to Winquist classification:type Ⅰ 14 cases, type Ⅱ 16 cases, type Ⅲ 34 case s, type IV 32 cases; according to AO classification:type 32-A 36 cases, type 32-B 44 cases, type 32-C in 14 cases. The time from injury to operation was 3～11 d, a verage 5 d. Patients will be according to the different choice of the medullary nailmet hods are divided into two groups:53 cases in group A, treated using electromagneti cnavigation interlocking intramedullary nail; B group of 43 cases, using the hand loc kingintramedullary nail in the treatment of. Comparison of two methods in the dista 2 pieces ofdistal locking screw locking successful time (from intramedullary nail mai n nail completelyinserted and fixed in the medullary to fluoroscopic confirmation seco nd gold distal lockingscrews were in good position so far), the one-time success rate and fluoroscopy time locking.Postoperative follow-up statistical time of fracture heali ng in patients with Lysholm scores,fracture healing, the comparison of two kinds o f intramedullary nail in the treatment of the patient after the recovery of limb functi on. Methods:2012 July-2014 February, admitted to Department of orthopedics cent er of the First Affiliated Hospital of Xinjiang Medical University and 96 cases of fe moral shaft fracture patients (patientsmeet the following criteria:age over 16 years o Id and under 60 years old with intramedullary nails operation indications of the patien ts), retrospective analysis. Causes of injury in 96 patients:44 cases, traffic accident in jury in high fall injury in 22 cases, falls in 14 cases, crush injury in 8 cases, other in jury in 6 cases.80 cases were male,16 were female; age 16-52 year old, average 3 8.3 years old. Open fracture in 6 cases, all Gustilo I injury; closed fracture in 90 cas es. Located in the proximal femoral fractures in 34 cases,48 cases of middle, lower segment in 14 cases. According to Winquist classification:type Ⅰ 14 cases, type Ⅱ 1 6 cases,type Ⅲ 34 cases, type Ⅳ 32 cases; according to AO classification:type 32-A 36 cases, type 32-B 44 cases, type 32-C in 14 cases. The time from injury to op eration was 3-11 d,average 5 d. Patients will be according to the different choice of the medullary nail methods are divided into two groups:53 cases in group A, treat ed using electromagnetic navigation interlocking intramedullary nail; B group of 43 c ases, using the hand locking intramedullary nail in the treatment of. Comparison oft wo methods in the distal 2 pieces of distal locking screw locking successful time (fro m intramedullary nail main nail completely inserted and fixedin the medullary to fluor oscopic confirmation second gold distal locking screws were in good position so fa r), the one-time success rate and fluoroscopy time locking. Postoperative follow-up stat istical time of fracture healing in patients with Lysholm scores, fracture healing, the comparison of two kinds of intramedullary nail in the treatment of the patient afte r the recovery of limb function. Results:In all 96 patients, femoral intramedullary n ail internal fixation for the treatment of patients withdistal naillocking,2 successfultim e:A group, B group,7min (5～9.5min) 18min (9 27min), with a significant difference be tween two groups (P<0.05); disposable locking success rate:A group of 50 cases of distal locking into power,3 cases of distal locking failure of distal locking nail, a sue cess rate of 94%, B group of 40 cases of distal locking successfully,13 cases ofdista 1 locking failure of distal locking nail, a success rate of 75%, with a significant diffe rence between two groups (P<0.05); A group of distal locking nail average fluorosco py time 2 seconds (range for 0-10 seconds) B group of intraoperative fluoroscopy ave rage time of 18 seconds (range 0-28 seconds), there was significant difference betwee n two groups (P<0.05):96 patients were followed up for 8-12 months, follow-up, an average of 9 months, fracture healing time:A group (14.5+1.5) weeks, group B(15. 4+1.6) weeks, two groups of no statistical difference (P>0.05); patients incision heal ed in I stage after operation, no skin necrosis, infections, sinus occurred early complic ations after operation. In 1 cases of hip painand the gluteus medius muscle strength i s abate electromagnetic navigation group, the symptoms disappeared after removing th e nail. Duringthefollow-upperiod, nobrokennails,nailretreat, infection, refracture occurre d. Postoperative follow-up of patients with Lysholm for 8 months, scoring:group A:th e results were excellent in 44 cases, good in 7 cases,2 cases,the excellent and goo d rate was 96%. Group B:the results were excellent in 36 cases, good in 5 cases,2 cases, the excellent and good rate was 95%:by two groups of treatment effect ofth e excellent and good rate comparison, found no statistically significant difference (P >0.05). Conclusion:Through the clinical retrospective analysis of two different ways of interlocking nail in the treatment of femoral shaft fracture:two Intramedullary na il in the treatment of femoral fractures backbone, have the effect of goodeffect, the fee ling function recovery in patients after operationConditions satisfied. And the electrom agnetic navigation over treatment and manual lockingintramedullary nail has the follow ing advantages of femoral shaft fracture by locking intramedullary nail:1)electromag netic navigation system relative to the manual interlocking intramedullary nail distal 1 ocking nail, simple procedure, intraoperative positioning is more accurate, significantly improve the success rate of distal locking nail; 2) in the electromagneticnavigation o n the distal interlocking intramedullary nail locking nail, can effectively reduce thetime of X-ray C arm X ray, even can do zero perspective, greatly reduce the radiation top hysicians and patients with injury operation.3) in electromagnetic navigation system assi steddistal locking nail, reduce the intraoperative distal locking nail positioning time, r educed in patients with soft tissue damage, reducing the probability of infection, woun d healing is convenient, echoing the minimally invasive principle of modern departmen t of orthopedics.Electromagnetic navigation system is a remote ideal locking system h as broad prospects ofclinical application.