北京生物医学工程

改良骨科术中侧位拍片暗盒固定支架的设计与应用

Design and application of a modified cassettefixation bracketfor the lateral radiograph in orthopedics

作者：李嫚刘宝强周正宏

单位：北京积水潭医院手术室（北京 100035） 通信作者：李嫚。E-mail：zhongzhel@126.com

分类号：R318.04

出版年·卷·期（页码）：2021·40·5（516-520）

摘要：

目的针对原有拍片支架易配重失衡和片盒与投射部位距离过大等技术难题，本文提出一种新的骨科术中侧位拍片暗盒固定支架。方法支架由五脚不锈钢底座支架、固定柱、升降柱、手柄式固定螺栓、推进滑轨、滑轨锁扣、滑轨固定螺栓、防脱螺母、暗盒固定柱、暗盒固定上、下边框及万向可锁定滑动轮组成。在原有骨科侧位拍片支架的设计基础上重新设计五脚不锈钢底座支架和万向滑动轮解决配重稳定问题；增加可推进暗盒固定滑轨，实现片盒贴近投照部位；增加滑轨锁扣和滑轨固定螺栓控制推进距离。通过观察实验组和对照组一次成像率和影像放大倍数，验证本设计的应用效果。结果实验组拍片时间同对照组比较，无显著性差异（P＞0.05），但拍片次数，一次成像率和图像放大倍数较对照组有显著性差异（P＜0.05）。采用改良侧位拍片支架相对原有侧位拍片支架虽然不能缩短拍片用时，但可以明显减少拍片次数，提高拍片的一次成像率和降低图像放大倍数。结论采用改良骨科术中侧位拍片暗盒固定支架进行侧位拍片，可获得99%的一次成像率和接近1的影像放大倍数，手术中应用效果满意，具有良好的临床应用前景。

Objective In order to solve technical problems such as the easy weight imbalance and the excessive distance between the box and the projection site of the original radiography bracket, this paper proposes a new fixation bracket for lateral radiography in orthopedic surgery. Methods The bracket is composed of a five-leg stainless steel base bracket, a fixing column, a lifting column, a handle type fixing bolt, a pushing slide rail, a sliding rail lock, a sliding rail fixing bolt, an anti-stripping nut, a cassette fixing column, a cassette fixing upper and lower frame and a universal locking sliding wheel. On the basis of the original orthopedic lateral photography bracket design, the five-legged stainless steel base bracket and the universal sliding wheel are redesigned to solve the problem of counterweight stability while the sliding rail is added with a pushable cartridge-box to fix the sliding rail so that the sliding box could be close to the projection position, and the sliding rail lock as well as the sliding rail fixing bolt is added to control the advancing distance. Moreover, the application effect of this design is verified by observing the primary imaging rate and image magnification of the experimental group and the control group respectively. Results The results show that there is no significant difference in filming time between the experimental group and the control group (P＞0.05), but there are significant differences in the shooting times, the first imaging rate and the image magnification (P < 0.05). Compared with the original lateral bracket, though the improved lateral bracket can not shorten the duration of radiography, it can significantly reduce the number of radiography, improve the primary imaging rate and reduce the image magnification. Conclusions The modified orthopedic intraoperative lateral radiography with carrier-fixator is able to achieve 99% of the first imaging rate and nearly 1:1 image magnification, which is satisfactory in operation and has a good clinical application prospect.

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