摘要
目的 探讨计算机辅助设计数字化钢板固定治疗髋臼后壁骨折伴髋关节脱位的临床效果. 方法 回顾性分析2012年6月至2016年8月期间收治的32例髋臼后壁骨折伴髋关节脱位患者资料.男22例,女10例;年龄为21～57岁,平均42.1岁.根据治疗方式不同分为2组：试验组（15例,采用数字钢板固定）和对照组（17例,采用传统钢板固定）.所有患者均采用Kocher-Langenbeck入路进行手术.试验组患者术前在计算机软件中模拟骨折复位,设计出个体化钢板,模拟钢板固定,最后生产出相应的数字化钢板.比较两组患者的手术时间、术中出血量、术中透视次数、术后住院时间、骨折复位质量、末次随访时髋关节功能及术后并发症发生情况等. 结果 试验组患者的手术时间[（73.3±15.2） min]较对照组患者[（93.2±14.7）min]短,术中出血量[（254.3±63.1） mL]和术中透视次数[（2.4±0.7）次]较对照组患者少[（334.6 ±70.3）mL、（3.2±0.8）次]少,差异均有统计学意义（P＜0.05）.试验组与对照组患者的骨折复位优良率分别为93.3％ （14/15）、88.2％（15/17）,差异无统计学意义（P＞0.05）.32例患者术后获8～ 48个月（平均28.1个月）随访.试验组和对照组患者末次随访时改良Merle d＇Aubigné＆Postel评分平均分别为（16.4±1.8）、（15.8±1.6）分,差异无统计学意义（P＞0.05）.试验组和对照组分别有1、3例患者发生异位骨化,差异有统计学意义（P＜0.05）. 结论 计算机辅助设计数字化钢板固定治疗髋臼后壁骨折伴髋关节脱位具有手术时间短、术中出血量少、透视次数少及异位骨化发生率低等优点.
Objective To evaluate the computer-aided design of digital plating for acetabular fracture of posterior wall associated with hip dislocation.Methods A retrospective study was conducted to analyze the 32 patients who had been admitted for acetabular fracture of posterior wall associated with hip dislocation between June 2012 and August 2016.They were 22 men and 10 women with a mean age of 42.1 years （from 21 to 57 years）.They were divided according to the treatment methods into 2 groups：an observational group （n =15） subjected to digital plating and a control group （n =17） subjected to conventional plating.All the patients were treated through the Kocher-Langenbeck approach.For the patients in the observational group,patient-specific digital steel plates were manufactured after simulation of fracture reduction,design of individualized steel plate and simulation of steel plating in the computer software before operation.The 2 groups were compared in terms of operation time,intraoperative bleeding,intraoperative fluoroscopy,hospital stay,fracture reduction and hip joint function at the last follow-up and postoperative complications as well.Results For the observational group,the operation time （73.3 ± 15.2 min） was significantly shorter than that for the control group （93.2 ± 14.7 min）,the intraoperative bleeding （254.3 ±63.lmL） and the intraoperative fluoroscopy （2.4 ± 0.7 times） were significantly less than those for the control group （334.6 ±70.3 mL;3.2 ±0.8 times） （P ＜ 0.05）.There were no significant difference between the 2 groups in the good to excellent rate of reduction [93.3％ （14/15） versus 88.2％ （15/17）] （P ＞ 0.05）.All the patients were followed up for an average of 28.1 months （from 8 to 48 months）.There was no significant difference either between the 2 groups in the modified Merle d＇Aubigné-Postel scores at the last follow-up （16.4 ± 1.8 versus 15.8 ± 1.6） （P ＞ 0.05）.There was a significant difference between the observational and control groups in the incidence of heterotopic ossification [6.7％ （1/1） versus 17.6％ （3/17）] （P ＜0.05）.Conclusions In the treatment ofacetabular fracture of posterior wall associated with hip dislocation,computer-aided design of digital plating may have advantages of shorter operation time,less intraoperative blood loss,less intraoperative fluoroscopy and lower incidence of heterotopic ossification.
作者
吴晓东
独行业
周正明
Wu Xiaodong;Du Xingye;Zhou Zhengming(Department of Orthopaedics, Jiangyin Hospital Affiliated to Southeast University, Wuxi 214400, China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2018年第5期439-442,共4页
Chinese Journal of Orthopaedic Trauma
基金
江苏无锡市卫生计生委重点项目（201708）
关键词
髋臼
骨折
骨折固定术
内
外科手术
计算机辅助
数字化技术
Acetabulum
Fractures
bone
Fracture fixation
internal
Surgery
computer-assisted
Digitization technology
