中国骨与关节损伤杂志

目的 通过股骨模型试验评估激光导向系统辅助股骨颈导针置入的准确性。方法 制作股骨近端模型40个，将模型编号后标记左右侧，随机分组，激光组采用激光导向系统辅助置入股骨颈导针，常规组徒手操作置入股骨颈导针，每组各20个股骨模型，左右侧股骨模型各10个。股骨颈部均置入3枚呈倒三角形分布的导针。比较两组操作时间、操作前透视次数、操作中透视次数、导针首次置入成功率、导针调整次数，以及前后位入针点偏离距离、前后位入针偏离角度、侧位入针偏离角度。结果 激光组操作时间较常规组短，操作前透视次数较常规组多，操作中透视次数较常规组少，导针置入首次成功率高于常规组，导针调整次数明显少于常规组，前后位入针点偏离距离较常规组小，前后位、侧位入针偏离角度较常规组小，差异有统计学意义（P<0.05）。结论 与常规徒手操作相比，在股骨颈模型中采用激光导向系统辅助置入导针的准确性更高，具有临床转化潜力。本研究的意义在于初步验证激光导向系统辅助置入股骨颈导针的可行性，为后期开展动物实验、尸体实验和临床试验研究提供支持。

Objective To evaluate the accuracy of femoral neck guide wires placement assisted by a laser guidance system with a femoral model experiment.Methods A total of 40 proximal femoral models were fabricated, numbered, and labeled for left/right identification. The models were randomly divided into two groups: the laser group(n=20), in which femoral neck guide wires were placed under the assistance of a laser guidance system, and the conventional group(n=20), in which guide wires were placed via freehand technique. Each group comprised 10 left and 10 right femoral models. Three guide wires were inserted into the femoral neck in an inverted triangular configuration in all models. The following parameters were compared between the two groups: operative time, number of fluoroscopic images acquired pre-operatively and intra-operatively, first-attempt success rate of guide wires placement, number of guide wires adjustments required, entry point deviation distance on anteroposterior(AP)view, entry angle deviation on AP view, and entry angle deviation on lateral view.Results Compared with the conventional group, the laser group had shorter operative time, more fluoroscopy sessions before the operation, fewer fluoroscopy sessions during the operation, a higher initial success rate of guide wires placement, and significantly fewer guide wires adjustments. In addition, the laser group showed smaller deviation distance of the entry point on the anteroposterior view, as well as smaller deviation angles of the entry point on both anteroposterior and lateral views. All differences were statistically significant(P<0.05).Conclusion Compared with conventional freehand manipulation, a laser guidance system assisted guide wires placement in femoral neck models offers higher accuracy and holds potential for clinical translation. The significance of this study lies in its preliminary validation of the feasibility of the laser guidance system for femoral neck guide wires placement, thereby providing support for future animal studies, cadaveric experiments, and clinical trials.