Auxiliary positioning of a new positioning device in internal fixation of femoral neck fracture with cannulated screws / 中国组织工程研究

BACKGROUND: At present, the application of intelligent positioning devices such as orthopedic robots and computer navigation systems in closed reduction surgery for femoral neck fractures is gradually developed, and grassroots hospitals still need a cheap auxiliary positioning device. OBJECTIVE: To investigate the effect of a Kirschner wire positioning device for assisted localization in internal fixation of femoral neck fracture with cannulated screws. METHODS: Fifty-four cases of femoral neck fracture treated in Binzhou Medical University Hospital from February 2016 to March 2018 were retrospectively analyzed. The patients were allocated into the two groups, 28 patients who received traditional cannulated screws internal fixation were in the traditional group, and 26 patients who received assisted localization internal fixation with cannulated screws were in the assisted localization group. The angle, direction and distance of the Kirschner wire could be quantified and fine-tuned, assisted with accurate positioning, and the placement of the cannulated screws was guided. Clinical and imaging data were compared between two groups. RESULTS AND CONCLUSION: (1) All patients received surgery successfully. No intraoperative complications such as vascular or nerve injury occurred. Postoperative image showed good fracture reduction, cannulated screw distribution, angle and position. (2) The operation time in the assisted localization group (49.27±4.86) minutes was shorter than that in the traditional group (59.64±8.02) minutes (P 0.05). The excellent and good rate of Harris score in the assisted localization group was 89%. (4) No necrosis of femoral head occurred during the follow-up, and the rate of late necrosis should be followed up. (5) Our findings suggest that Kirschner wire positioning device can assist in quantitative positioning and guide the placement of cannulated screw in the internal fixation of femoral neck fracture. It can effectively improve the positioning efficiency, reduce the number of fluoroscopy, avoid repeatedly adjusting the penetration to damage femoral neck bone, and promote the recovery of patients.

Design of CT-guided puncture positioning device / 医疗卫生装备

Objective To design a CT-guided puncture positioning device to shorten puncture time while increase the accuracy. Methods The device realized 3D positioning by the principle of plane geometry, which was composed of a positioner,a fixation mechanism and a direction guiding mechanism for puncture needle.The positioner and direction guiding mechanism were made of transparent plastic, and the fixation mechanism was made of elastic cloth. Results The device gained advantages over the traditional means in puncture time,times of needle insertion and times of CT scanning,and had the puncture success rate in one time being 90%. Conclusion The device behaves well in focal positioning and puncture needle guiding,and thus decreases the probability of failed puncture and the patient pains.

A comparative research between traditional positioning device and a new type percutaneous kyphoplasty positioning device / 中国医学装备

Objective:To compare the accuracy and safety between percutaneous kyphoplasty (PKP) positioning device and traditional positioning device which posit entry point of pedicle of vertebral arch by using the C-arm X-ray.Methods: 117 patients with spinal centrum compression fractures were divided into positioning device group (57 cases) and Kirschner wire group (60 cases) depended on the entry point marked by the preoperative C arm X-ray irradiation. To compare the excellence rate, operation time and exposure times between PKP positioning device and traditional device.Results: The positioning times of the PKP positioning device group and Kirschner wire group were (2.3±0.9)min and (6.8±1.3)min, respectively. The exposure times of the two group were 1.6 times and 4.7 times, respectively. And both of the two differences were statistical significant (t=21.062,t=18.521;P0.05).Conclusion: There are series of advantages in developed PKP positioning device, such as portable, easy and simple control, higher accuracy and safety, less positioning time and exposure times of C arm X-ray.

Application of CT-guided self-made localization puncture device in radiofrequency ablation of liver tumors / 肿瘤研究与临床

Objective To evaluate the value of CT-guided self-made positioning puncture device in radiofrequency ablation of liver tumors. Methods A total of 78 tumor foci from 64 patients with primary hepatocellular carcinoma treated with radiofrequency ablation from January 2010 to November 2014 were analyzed. Among them, 13 tumor diameters were 3.5-5.0 cm and 65 < 3.5 cm. The location and puncture of tumor lesion were performed by CT-guided positioning device, and the effect of puncture and lesion was evaluated by using tumor precise radiotherapy planning system. Radiofrequency ablation of tumor lesion was performed by tumor radiofrequency treatment system. Results The puncture error of all tumors in the space was 1-4 mm, the average puncture error was 2.9 mm, the complete ablation rate of tumor lesions was 93.59%(73/78), and there was no serious complication in the course of treatment. After treatment, the alpha-fetoprotein and liver function were significantly improved, and the differences were statistically significant (both P<0.05). At 1 month after surgery, CT found that no tumor and ablation was enhanced, at 3 months after surgery, CT showed that the arterial phase of all the tumor lesions did not strengthen, all of them were low-density lesions, no ablation recurred. The recurrence rates of 1, 2, 3, and 4 years after treatment were 17.9 %, 29.9 %, 45.9 % and 55.0 %. Conclusion CT-guided radiofrequency ablation with self-made puncture device is effective in the diagnosis of primary liver cancer, ablation is complete and safe.

Application of a self-made positioning device in laryngeal CT-MRI image fusion / 中华放射肿瘤学杂志

Objective To investigate the application of a self-made positioning device in CT-MRI image fusion in patients with laryngeal tumor,as well as the precision of image fusion and the changes in target volume delineation after fusion.Methods A total of 10 patients with laryngeal cancer were enrolled,and a self-made positioning device was used to collect CT and MRI images in a fixed position.These images were fused by mutual information combined with manual fusion.The precision of image fusion was assessed by the positional deviation of internal and external markers and degree of gross tumor volume (GTV) overlap (PCT-MRI) between CT and MRI images.GTV was contoured based on CT images (VCr),MRI images (VMRI),and fused images (VCT+MRI).The overlapped volume of VCT and VMRI(VCT-MRI) Was calculated,and the target volume was analyzed and compared.Results The positional deviations of three external markers in the three directions were 0.996±0.222 mm,1.146±0.291 mm,and 1.368±0.298 mm (P=0.000),respectively,while those of the internal markers were 0.476±0.151 mm,0.561±0.083 mm,and 0.724± 0.125 mm (P=0.000),respectively.VCT,VMRI,VCT+MRI,and VCT-MRI were 26.355±7.876 cm3,33.556± 7.407 cm3,40.036±7.627 cm3,19.875±8.588 cm3(P=0.000),respectively.PCT-MRI was 73.7％±9.8％.Conclusions The self-made positioning device can improve the consistency of position during the collection of CT and MRI images,and fused CT-MRI images can provide more information and improve the precision of target volume delineation.

CAD/CAM splint based on soft tissue 3D simulation for treatment of facial asymmetry / 대한악안면성형재건외과학회지

BACKGROUND: Most cases of facial asymmetry involve yaw deformity, and determination of the yaw correction level is very difficult. METHODS: We use three-dimensional soft tissue simulation to determine the yaw correction level. This three-dimensional simulation is based on the addition of cephalometric prediction to gradual yaw correction. Optimal yaw correction is determined visually, and an intermediate splint is fabricated with computer-aided design and computer-aided manufacturing. Application of positioning devices and the performance of horseshoe osteotomy are advisable. RESULTS: With this procedure, accurate repositioning of jaws was confirmed and patients obtained fairly good facial contour. CONCLUSIONS: This procedure is a promising method for a widespread, predictable treatment of facial asymmetry.

The positional change of condylar head after orthognathic surgery using simplified condyle positioning device