ObjectiveTo investigate the application and effectiveness of self-made spring plate in surgical treatment of acetabular posterior wall fracturejavascript:void(0)s.MethodsBetween June 2013 and June 2017, 38 patients with acetabular posterior wall fractures were treated. There were 27 males and 11 females with an average age of 53 years (range, 28-68 years). The injury caused by traffic accident in 18 cases, falling from height in 15 cases, and tumble in 5 cases. There were 4 cases of simple posterior wall fracture, 18 cases of posterior wall fracture with posterior dislocation of hip joint, 10 cases of posterior wall fracture with posterior column fracture, and 6 cases of posterior wall fracture with transverse fracture. The time from injury to admission was 1-4 days (mean, 2.5 days). The time from injury to operation was 4-8 days (mean, 5 days). After fracture reduction via the Kocher-Langenbeck approach (35 cases) or the combined ilioinguinal approach (3 cases), the spring plate was used to press the posterior wall fracture, and then the reconstruction plate was pressed against the spring plate and fixed to the posterior column.ResultsAll the incisions healed by first intention. All patients were followed up 12-36 months (mean, 28 months). Five cases of post-traumatic sciatic nerve injury and 2 cases of sciatic nerve injury caused by traction during operation were fully recovered at 3 months after operation. The imaging examination showed that all the fractures healed. The fracture healing time was 10-16 weeks (mean, 12 weeks). There was no ruptures or failures of internal fixation during the follow-up period. There were 2 cases of femoral head necrosis, 1 case of traumatic arthritis, and 1 case of osteomyositis at last follow-up. The hip joint function was rated as excellent in 27 cases, good in 5 cases, fair in 2 cases, and poor in 4 cases according to the Harris scores at 12 months after operation.ConclusionFor the acetabular posterior wall fracture, it has the advantages of easy to use and reliable fixation that the posterior wall fracture is fixed with spring plate firstly, and the spring plate is pressed to fix the posterior column with the reconstruction plate finally.
目的 分析比较锥形束CT(CBCT)与MOSAIQ两系统用于测量胸部放射治疗(放疗)摆位误差情况。 方法 2011年2月－9月,随机选择21例用热塑模固定的胸部调强治疗患者，进行同次摆位的CBCT图像采集和电子射野影像(EPID)正侧位图像采集。将CBCT图像与定位CT图像进行匹配，图像经iViewGT系统传输至MOSAIQ系统图像处理模块中与计划生成的数字重建图像(DRR)正侧位片进行匹配，分别记录两套系统图像匹配结果在X(左右)方向、Y(头脚)方向、Z(前后)方向的平移误差及CBCT的旋转误差值，计算其均值、标准差，进行统计学处理。 结果 本研究共获取图像106组，每组内包含一次CBCT图像和EPID图像。CBCT和MOSAIQ系统下EPID匹配结果平移误差在X、Y、Z方向分别为(−0.103 ± 0.240)cm、(−0.086 ± 0.342)cm、(0.017 ± 0184)cm和(0.005 ± 0.214)cm、(−0.004 ± 0.0.315)cm、(−0.113 ± 0.239)cm；旋转误差在X、Y、Z方向分别为(0.792 ± 1.173)°、(−0.130 ± 1.407)°、(0.793 ± 0.960)°，其中≤3°的概率分别为98.2%、97.2%、99.1%，最大绝对值分别为5°、3.4°、3.3°。两套系统在X、Y、Z三个方向的平移误差经配对样本检验，在Y方向P＞0.05，在X和Z方向上P值均＜0.05， 两系统的测量差值有直线负相关关系。 结论 CBCT和EPID在测量胸部放疗靶区中心的平移误差中差异有统计学意义，因此建议在做胸部放疗时有CBCT的情况下应优先使用。