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BACKGROUND: Vertebroplasty or kyphoplasty is monitored under imaging apparatus. Standard entopic phase and standard lateral phase were obtained via repeatedly adjusting C-arm preoperatively. Puncturing angle was adjusted in experience, and time and X-ray exposure were significantly increased. OBJECTIVE: To design percutaneously puncturing apparatus for vertebrae in order to reduce X-ray exposure and shorten the operating time. DESIGN, TIME AND SETTING: A designing and verifying study was performed at the Department of Orthopaedics, the First Hospital Affiliated to Soochow University between October 2004 and March 2005. MATERIALS: Five samples of thoracic waist and lumbar vertebrae with soft tissues did not have abnormalities or defect. METHODS: CT scan and standard lateral image of 5 vertebrae specimen from T11 to L5 were got. Every "e" angle and "f" angle were measured and puncturing approaches were analyzed for kyphoplasty in thoracic and lumbar vertebrae. Percutaneously guiding instrument was only used on the left sides. The effect was analyzed and the exposure times were compared between the left and the right sides. MAIN OUTCOME MEASURES: Determination of puncturing approach, and X-ray exposure times between the left and the right sides. RESULTS: The entry point was at the superior-lateral 1/4 quadrant of the cross by a line passed the mid-point of two transverse process roots and a line passed the back edge of the superior articular process. In standard anterior posterior image, the entry points were at 2 o'clock on the left pedicle shadow and 10 o'clock on the right pedicle shadow respectively. The exposure times were 12.61±1.69 on the left and 23.19±1.60 on the right (P < 0.05).CONCLUSION: Ideal position can be arrived in puncturing according to the exact position, correct entry point and puncturing according to te exact position,correct entry point and puncturing angles.Application of percutaneously guiding instrument can sgnificantly diminish exposure time.
RESUMO
OBJECTIVE:To discuss the choice of artificial thigh bone prosthetic material and curative effects of artificial thigh bone prosthesis for treating femur intertrochanteric comminuted fracture of senior patients.METHODS:We retrieved China National Knowledge Infrastructure (CNKI) in Chinese (1977/2009) and Medline database in English (1977/2009) with the key words of "femur intertrochanteric fracture;artificial femoral head arthroplasty;elderly patient".Totally 83 articles were retrieved,and 34 articles were included in accordance with inclusion and exclusion criteria.Literatures addressing artificial thigh bone prosthesis,intertrochanteric fracture in elderly patients and artificial femoral head replacement in treatment of femur intertrochanteric fracture were summarized,and curative effect of artificial thigh bone prosthesis for treating intertrochanteric fracture in elderly patients was explored.RESULTS:Artificial thigh bone prosthesis had been widely used in treatment of various femur intertrochantedc fractures.There are many types of artificial thigh bone prosthesis such as metal material,high polymer polyethylene,ceramic material and carbon material,which had obtained significant outcomes.Function of artificial thigh bone prosthesis was improved gradually,and became widely in clinic.Artificial thigh bone prosthesis has presently been an optimal method for treating femur intertrochanteric comminuted fracture in elderly patients.However,this method exist many problems that require to be solved such as high operation risk and many complications.CONCLUSION:There are many materials for choosing artificial thigh bone prosthesis,with various advantages and disadvantages.Presently,complex artificial thigh bone prosthesis is commonly used in clinic.Artificial thigh bone prosthesis is an ideal method to treat femur intertrochanteric comminuted fracture of elderly patients.