定位装置辅助下四肢深部金属异物的精准定位及取出

doi:10.13418/j.issn.1001-165x.2021.02.007

Abstract

Abstract: Objective　To explore the application of the new positioning device on the accurate localization and removal surgery of deeply imbedded metallic foreign bodies.　Methods　Ten human limb specimens were used and 65 metal balls with a diameter of 2.0 mm were inserted. This experiment was divided into an experimental group, which was the actual locating result of the 65 cases of foreign bodies, and a control group, which was the theoretical optimal locating result of the 65 cases of foreign bodies. After localization with assistance of the locating device, a thin layer CT scan and 3D reconstruction were performed to measure the positioning deviation distance (D1). The qualified positioning numbers of different accuracy levels was counted. The chi square test was performed to obtain the positioning accuracy of the locating device and the fluoroscopy time (T1) and removal time of the foreign body (T2) were recorded.　Results　All 65 metallic foreign bodies were located and removed precisely, with mean T1: 46.06±18.44 seconds and T2: 177.10±65.87 seconds. The location accuracy of this device was 2.3mm.　Conclusions　With the aid of this positioning device, the precise localization and removal of deeply embedded metallic foreign bodies in human limbs can be achieved.

Key words: Retained metallic foreign body, 　Precise positioning, 　3D printing, 　Fluoroscopy

CLC Number:

R608

Su Weiwei, He Zaopeng, Zhang Guodong, Li Wei, Xu Jing, Liao Zhengwen, Xie Pusheng, Lin Dongxin, Huang Wenhua. Accurate localization and removal of deeply imbedded metallic foreign bodies in human limbs assisted by positioning device[J]. Chinese Journal of Clinical Anatomy, 2021, 39(2): 148-153.

References 17

[1]	Cima RR, Kollengode A, Garnatz J, et al. Incidence and characteristics of potential and actual retained foreign object events in surgical patients[J]. J Am Coll Surg, 2008, 207(1): 80-87. DOI:10.1016/j.jamcollsurg. 2007. 12.047.
[2]	O'Brien L, Eyster KM, Hansen KA. Retained foreign body: “needle in a haystack”[J]. J Patient Saf, 2015, 11(4): 228-229. DOI: 10.1097/PTS.0000000000000078.
[3]	Su YX, Nan GX. Using methylene blue as a marker to find and remove tiny metallic foreign bodies embedded in the soft tissues of children: a randomised controlled trial[J]. Int J Surg, 2016, 29: 43-48. DOI: 10.1016/j.ijsu.2016.03.018.
[4]	Teltzrow T, Hallermann C, Müller S, et al. Foreign body-induced angiosarcoma 60 years after a shell splinter injury[J]. Mund Kiefer Gesichtschir, 2006, 10(6): 415-418. DOI: 10.1007/s10006-006-0026-4.
[5]	Xing GF, Shi CW, Qian HX, et al. Novel methods of removing metallic foreign body from human soft tissue: a report of 7390 cases[J]. J Surg Res, 2013, 183(1): 337-340. DOI: 10.1016/j.jss.2012.12.018.
[6]	He B, Xu C, Mao Y, et al. A novel navigation system to guide metallic foreign body extraction[J]. Int J Comput Assist Radiol Surg, 2016, 11(11): 2105-2110. DOI: 10.1007/s11548-016-1424-1.
[7]	Lorenz KJ, Böckers A, Fassnacht U, et al. Implementation of a miniaturised navigation system in head and neck surgery for the detection and removal of foreign bodies[J]. Eur Arch Otorhinolaryngol, 2017, 274(1): 553-559. DOI: 10.1007/s00405-016-4212-1.
[8]	Zhang GD, Yu ZX, Chen XH, et al. Accurate placement of cervical pedicle screws using 3D-printed navigational templates: an improved technique with continuous image registration[J]. Orthopade, 2018, 47(5): 428-436. DOI: 10.1007/s00132-017-3515-2.
[9]	Yu ZX, Zhang GD, Chen XH, et al. Application of a novel 3D drill template for cervical pedicle screw tunnel design: a cadaveric study[J]. Eur Spine J, 2017, 26(9): 2348-2356. DOI: 10.1007/s00586-017-5118-3.
[10]	Xu J, He ZP, Zhang GD, et al. An experimental study on the digital precision of internal fixation via the sinus tarsi approach for calcaneal fractures[J]. J Orthop Surg (Hong Kong), 2019, 27(1): 2309499019 834072. DOI: 10.1177/2309499019834072.
[11]	Zhu QH, Chen Y, Zeng QL, et al. Percutaneous extraction of deeply-embedded radiopaque foreign bodies using a less-invasive technique under image guidance[J]. J Trauma Acute Care Surg, 2012, 72(1): 302-305. DOI: 10.1097/TA.0b013e31822c1c50.
[12]	Tantray MD, Rather A, Manaan Q, et al. Role of ultrasound in detection of radiolucent foreign bodies in extremities[J]. Strategies Trauma Limb Reconstr, 2018, 13(2): 81-85. DOI: 10.1007/s11751-018-0308-z.
[13]	Ma H, Jh K. Diagnostic X-rRay exposure and thyroid cancer risk: systematic review and meta-analysis[J]. Thyroid, 2018, 28(2): 220-228. DOI: 10.1089/thy.2017.0159.
[14]	Hendee WR. History, current status, and trends of radiation protection standards[J]. Med Phys, 1993, 20(5): 1303-1314. DOI: 10.1118/1.597153.
[15]	Marant Micallef C, Shield KD, Vignat J, et al. The risk of cancer attributable to diagnostic medical radiation: estimation for France in 2015[J]. Int J Cancer, 2019, 144(12): 2954-2963. DOI: 10.1002/ijc.32048.
[16]	Lim H, Choi J, Kim JH, et al. Estimation of cancer incidence and mortality risks attributed to diagnostic medical radiation exposure in Korea, 2013[J]. J Korean Med Sci, 2018, 33(29): e211. DOI: 10.3346/jkms.2018.33.e211.
[17]	Qian HX, Qin XJ, Xing GF, et al. Comparison of the efficacy and characteristics of metallic foreign body extraction by incision surgery and x-ray guided forceps after body-surface projection positioning: a STROBE-compliant article[J]. Medicine (Baltimore), 2018, 97(35): e12116. DOI: 10.1097/MD.0000000000012116.

Accurate localization and removal of deeply imbedded metallic foreign bodies in human limbs assisted by positioning device

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