Department of Orthopaedics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.
, H-3/130, sector-11, Rohini, New Delhi, 110085, India.
Eur J Trauma Emerg Surg. 2022 Apr;48(2):1255-1261. doi: 10.1007/s00068-021-01617-z. Epub 2021 Mar 8.
Open reduction and internal fixation is a standard treatment for displaced acetabular fractures using 3.5 mm reconstruction plates contoured intra-operatively. This process is difficult and time consuming hence resulting in increased surgical morbidity. Virtual surgical planning is now being commonly used worldwide to aid in management of such complex problems. Patient-specific reconstruction plate pre contoured using virtual surgical planning on contralateral intact hemipelvis will be helpful in achieving better surgical outcomes. Also, it has an added advantage of considerably reducing the time and effort spent in virtual pre-operative planning process.
This study was performed in 30 patients with acetabulum fracture who were fixed posteriorly via Kocher-Langenbeck approach. Virtual planning was done on contralateral hemipelvis to prepare patient-specific pre-contoured plates and mirrored to the fractured side. The time required for virtual planning on fractured and normal side was recorded and compared. The efficiency of plates so prepared were accessed in terms of outcome variables like duration of surgery, blood loss, reduction obtained on X-ray as well as CT Scan.
Time required for virtual planning was more on fractured side and lesser when it was done using normal hemipelvis with mean values of 81.83 (sd = 28.02) min and 15.67 (sd = 6.12) min, respectively. Values of blood loss, duration of surgery and reduction as accessed on X-ray and CT scan were comparable or even better than compared to other studies.
Contralateral normal pelvis can be used for virtual preoperative planning making the whole process easier and less time consuming.
使用 3.5 毫米重建钢板进行术中塑形的切开复位内固定是治疗移位髋臼骨折的标准治疗方法。这个过程既困难又耗时，因此导致手术发病率增加。虚拟手术规划现在在全球范围内被广泛用于辅助处理此类复杂问题。使用对侧完整骨盆上的虚拟手术规划对患者专用重建板进行预塑形将有助于获得更好的手术结果。此外，它还有一个额外的优势，可以大大减少虚拟术前规划过程中花费的时间和精力。
本研究纳入了 30 例髋臼骨折患者，这些患者通过 Kocher-Langenbeck 入路行后路固定。在对侧半骨盆上进行虚拟规划，以准备患者专用的预塑形板，并镜像到骨折侧。记录并比较骨折侧和正常侧虚拟规划所需的时间。根据手术时间、出血量、X 线和 CT 扫描获得的复位等结果变量评估准备好的钢板的效率。
骨折侧虚拟规划所需的时间更多，而使用正常半骨盆时所需的时间更少，平均值分别为 81.83（标准差=28.02）分钟和 15.67（标准差=6.12）分钟。X 线和 CT 扫描评估的出血量、手术时间和复位值与其他研究相比相当，甚至更好。
可以使用对侧正常骨盆进行虚拟术前规划，使整个过程更容易、耗时更少。
