[APPLICATION RESEARCH OF USING OSTEOTOMY GUIDE DEVICE IN OSTETOMY WITH MULTIPLE DRILL HOLES]

To study the function and effectiveness of self-manufacture osteotomy guide device in osteotomy.

A guide device was manufactured, which could guide the drill and osteotome. Sixty femoral moulds which cover with bubble were used as human femurs, and a 3 cm long, 1 cm wide crack was made in the femoral moulds supracondylar to imitate operation incision. The femoral moulds were divided into 3 groups (n = 20): non-guiding group (group A), simple drill guiding group (group B), and drill-osteotome guiding group (group C). The osteotomy time, the variation range of the drill holes (incision side and the contralateral side), the variation range of the osteotome incisions (incision side and the contralateral side), and the match rate of drill holes and osteotome incision were recorded. And between February 2013 and January 2014, the osteotomy guide device was used to guide proximal tibia osteotomy in 6 patients with tibia infected nonunion to excise of infected bones.

The osteotomy time of groups B and C was significantly less than that of group A, and it was significantly less in group C than group B (P < 0.01). The match rate of drill holes and osteotome incision in groups B and C was significantly higher than that of group A, and group C was significantly higher than group B (P < 0.05). The variation range of the drill holes in both incision side and contralateral side of groups B and C was 0, which was significantly less than that of group A (P < 0.01). The variation range of the osteotome incisions in both incision side and contralateral side of groups B and C was significantly less than that of group A, group C was significantly less than group B (P < 0.01). Preliminary clinical results showed that the osteotomy guide device was simple to use, and precise in guidance for drill and osteotome, so it could reduce the time for repeated targeting during drilling and osteoming. The osteotomy time was 8.3-11.2 minutes (mean, 9.5 minutes). The surface of osteotomy was smooth and no split; and there was rich callus formation during bone transport. Six patients were followed up 13-25 months (mean, 16 months). The bone healing index was 0.92 ± 0.13.

The osteotomy guide device can reduce the damage to surrounding tissue and bone caused by drill and osteotome, reduce the difficulty of osteotomy, and significantly shorten the cost time.