电阻应变式传感器在下肢牵引手术中的应用

Application of resistive strain gauge sensor as a novel measurement tool in lower limb traction surgery

摘要:

目的 研究电阻应变式传感器（RSS）在不同下肢骨折类型手术中的应用。方法 选择2020年10月—2022年8月中国科学技术大学附属第一医院收治的外伤性下肢骨折患者99例，按照骨折类型分为股骨粗隆间骨折组79例、股骨干骨折组15例、股骨颈骨折组5例。患者均在牵引床上行闭合复位内固定术，使用RSS测量3组不同骨折类型手术中的初始牵引力、牵引时长、松解牵引力。记录手术时间、术中出血量，术后评分及3组不同骨折类型手术前后血色素变化及输血情况；比较使用不同内固定方式（长髓内钉、短髓内钉、空心钉）的术中牵引力和手术出血量、手术时间；比较长髓内钉固定患者和短髓内钉固定患者时下肢旋转角度。结果 3组不同骨折类型初始牵引力、牵引时长、松解牵引力、手术时长、术中出血量、术后评分比较，差异均有统计学意义（P <0.05）。3组不同骨折类型术前、术后血红蛋白、红细胞压积比较，差异均有统计学意义（P <0.05）。3组术中输血情况比较，差异有统计学意义（P <0.05），术后输血情况比较，差异无统计学意义（P >0.05）。使用不同内固定方式的患者牵引总时长、年龄、术中出血量、手术时间比较，差异均有统计学意义（P <0.05）；初始牵引力、松解牵引力比较，差异均无统计学意义（P >0.05）。长髓内钉固定患者和短髓内钉固定患者下肢旋转角度比较，差异无统计学意义（P >0.05）。结论 术中使用RSS可以获取下肢牵引力的详细数值，从而保障手术的安全，为智能化复位收集资料。

Abstract:

Objective To measure and study the changes in intraoperative traction values of different types of lower limb fractures by using resistive strain gauge sensors (RSS), and to analyze relevant surgical data.Methods From October 2020 to August 2022, 99 patients with traumatic lower limb fractures were selected from The First Affiliated Hospital of University of Science and Technology of China, and there were three types of fractures: intertrochanteric fracture group (n = 79), femoral shaft neck fracture group (n = 15), and femoral neck shaft fracture group (n = 5). The patients underwent closed reduction and internal fixation surgery on the traction bed, and the initial traction force, traction duration, and traction force value at release in three different types of fracture surgeries were measured using RSS. The surgical time, intraoperative bleeding, postoperative score, and changes in hemoglobin and blood transfusion before and after surgery for the three different types of fractures were recorded; the intraoperative traction value, surgical bleeding volume, and surgical time of different internal fixation methods (long intramedullary nails, short intramedullary nails, and multiple hollow nails) were compared; the difference in lower limb rotation angle was compared between patients with long intramedullary nails fixation and patients with short intramedullary nails fixation.Results There were differences in initial traction force, traction duration, traction force value at release, surgical duration, intraoperative bleeding, and postoperative score among the three groups of different fracture types (P < 0.05). There were differences in preoperative and postoperative hemoglobin and hematocrit among the three groups of different fracture types (P < 0.05). There was a difference in intraoperative blood transfusion among the three groups (P < 0.05), while there was no statistically significant difference in postoperative blood transfusion (P > 0.05). There were differences in total traction time, age, bleeding volume, and surgical time among patients using different internal fixation methods (P > 0.05); but there was no statistically significant difference in the initial traction force and the traction force value at release (P > 0.05). There was no statistically significant difference in lower limb rotation angle between patients with long intramedullary nails fixation and patients with short intramedullary nails fixation (P > 0.05).Conclusion The use of RSS during surgery can obtain detailed values of lower limb traction force, thereby ensuring the safety of surgery and collecting data for intelligent reduction.