This study describes the development of a cervical traction therapy simulation model that evaluates two types of the traction positions, namely the sitting position and the inclined position. An anatomically correct h...This study describes the development of a cervical traction therapy simulation model that evaluates two types of the traction positions, namely the sitting position and the inclined position. An anatomically correct human skeleton model and two mechanical traction device models were constructed in simulations using a physics engine. The anterior and posterior intervertebral separations were measured at both positions with a series of traction forces (60N to 200N) and traction angles (10°? to 40°?). The result suggested that the sitting position caused the subject to lean forward and as a result led to excessive anterior compression when traction angle is over 20 degrees. The inclined position creates greater intervertebral separations on both the anterior and posterior sides than the sitting position. This suggests that the inclined position may be more effective in increasing intervertebral separation than the sitting position.展开更多
目的:探讨股骨近端防旋髓内钉(Proximal Femoral Nail Antirotation,PFNA)治疗股骨粗隆间骨折在无牵引床平卧位下的手术方法及临床效果。方法:对150例股骨粗隆间骨折行股骨近端防旋髓内钉内固定患者根据手术体位方式分为对照组:第一组...目的:探讨股骨近端防旋髓内钉(Proximal Femoral Nail Antirotation,PFNA)治疗股骨粗隆间骨折在无牵引床平卧位下的手术方法及临床效果。方法:对150例股骨粗隆间骨折行股骨近端防旋髓内钉内固定患者根据手术体位方式分为对照组:第一组牵引床组(50例)、第二组侧卧位组(50例)和治疗组:第三组无牵引床改良平卧位组(50例)。对三组的住院时间、术中X线透视次数、切口平均长度、手术时长、术中出血量、术后骨折复位效果、术后深静脉血栓形成和髋关节内翻例数、骨折愈合时间进行比较,按照Harris评分评价三组治疗效果。结果:患者均获得随访,随访8~12个月,术中X线透视次数、术中出血量、手术时长比较差异有统计学意义(P<0.05)。三组术后髋关节内翻发生率和深静脉血栓形成比较差异无统计学意义(P>0.05)。髋关节Harris评分优良率差异无统计学意义(P>0.05)。结论:在无牵引床改良平卧位条件下使用股骨近端防旋髓内钉微创治疗股骨粗隆间骨折,治疗效果满意,与侧卧位、使用牵引床条件下手术效果相似,手术时间甚至更优。随访8~12个月。三组的骨折复位效果、骨折愈合时间、住院时间比较差异等无统计学意义(P>0.05)。结论:对成人股骨粗隆间骨折,多采用手术治疗,基层医院由于技术及资金等原因,一般很少配置牵引床导致多使用侧卧位进行手术,术中复位后需助手固定透视,或使用旧式牵引床,消耗大量时间调试牵引床复位,多年的观察也发现其存在一定的不足。本研究采用无牵引床改良平卧位股骨近端防旋髓内钉微创治疗股骨粗隆间骨折,并与前两种手术方式进行比较,也取得满意的疗效。展开更多
文摘This study describes the development of a cervical traction therapy simulation model that evaluates two types of the traction positions, namely the sitting position and the inclined position. An anatomically correct human skeleton model and two mechanical traction device models were constructed in simulations using a physics engine. The anterior and posterior intervertebral separations were measured at both positions with a series of traction forces (60N to 200N) and traction angles (10°? to 40°?). The result suggested that the sitting position caused the subject to lean forward and as a result led to excessive anterior compression when traction angle is over 20 degrees. The inclined position creates greater intervertebral separations on both the anterior and posterior sides than the sitting position. This suggests that the inclined position may be more effective in increasing intervertebral separation than the sitting position.
文摘目的:探讨股骨近端防旋髓内钉(Proximal Femoral Nail Antirotation,PFNA)治疗股骨粗隆间骨折在无牵引床平卧位下的手术方法及临床效果。方法:对150例股骨粗隆间骨折行股骨近端防旋髓内钉内固定患者根据手术体位方式分为对照组:第一组牵引床组(50例)、第二组侧卧位组(50例)和治疗组:第三组无牵引床改良平卧位组(50例)。对三组的住院时间、术中X线透视次数、切口平均长度、手术时长、术中出血量、术后骨折复位效果、术后深静脉血栓形成和髋关节内翻例数、骨折愈合时间进行比较,按照Harris评分评价三组治疗效果。结果:患者均获得随访,随访8~12个月,术中X线透视次数、术中出血量、手术时长比较差异有统计学意义(P<0.05)。三组术后髋关节内翻发生率和深静脉血栓形成比较差异无统计学意义(P>0.05)。髋关节Harris评分优良率差异无统计学意义(P>0.05)。结论:在无牵引床改良平卧位条件下使用股骨近端防旋髓内钉微创治疗股骨粗隆间骨折,治疗效果满意,与侧卧位、使用牵引床条件下手术效果相似,手术时间甚至更优。随访8~12个月。三组的骨折复位效果、骨折愈合时间、住院时间比较差异等无统计学意义(P>0.05)。结论:对成人股骨粗隆间骨折,多采用手术治疗,基层医院由于技术及资金等原因,一般很少配置牵引床导致多使用侧卧位进行手术,术中复位后需助手固定透视,或使用旧式牵引床,消耗大量时间调试牵引床复位,多年的观察也发现其存在一定的不足。本研究采用无牵引床改良平卧位股骨近端防旋髓内钉微创治疗股骨粗隆间骨折,并与前两种手术方式进行比较,也取得满意的疗效。
