采用 Taylor 空间框架治疗胫骨骨折时的标记三维测量与传统放射测量比较。

Marker- three dimensional measurement versus traditional radiographic measurement in the treatment of tibial fracture using Taylor spatial frame.

机构信息

Graduate College of Tianjin Medical University, Tianjin, China.

Department of Trauma and Microreconstructive surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.

出版信息

BMC Musculoskelet Disord. 2022 Feb 16;23(1):155. doi: 10.1186/s12891-022-05112-3.

DOI:10.1186/s12891-022-05112-3

PMID:35172802

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8849035/

Abstract

BACKGROUND

The Taylor Spatial Frame (TSF) has been widely used for tibial fracture. However, traditional radiographic measurement method is complicated and the reduction accuracy is affected by various factors. The purpose of this study was to propose a new marker- three dimensional (3D) measurement method and determine the differences of reduction outcomes, if any, between marker-3D measurement method and traditional radiographic measurement in the TSF treatment.

METHODS

Forty-one patients with tibial fracture treated by TSF in our institution were retrospectively analyzed from January 2016 to June 2019, including 21 patients in the marker-3D measurement group (experimental group) and 20 patients in the traditional radiographic measurement group (control group). In the experimental group, 3D reconstruction with 6 markers installed on the TSF was performed to determine the electronic prescription. In the control group, the anteroposterior (AP) and lateral radiographs were performed for the traditional parameter measurements. The effectiveness was evaluated by the residual displacement deformity (RDD) and residual angle deformity (RAD) in the coronal and sagittal plane, according to the AP and lateral X-rays after reduction.

RESULTS

All patients achieved functional reduction. The residual RDD in AP view was 0.5 (0, 1.72) mm in experimental group and 1.74 (0.43, 3.67) mm in control group. The residual RAD in AP view was 0 (0, 1.25) ° in experimental group and 1.25 (0.62, 1.95) °in control group. As for the lateral view, the RDD was 0 (0, 1.22) mm in experimental group and 2.02 (0, 3.74) mm in control group, the RAD was 0 (0, 0) ° in experimental group and 1.42 (0, 1.93) ° in control group. Significant differences in all above comparisons were observed between the two groups (AP view RDD: P = 0.024, RAD: P = 0.020; Lateral view RDD: P = 0.016, RAD: P = 0.004).

CONCLUSIONS

The present study introduced a marker-3D measurement method to complement the current TSF treatment. This method avoids the manual measurement error and improves the accuracy of fracture reduction, providing potential advantages of bone healing and function rehabilitation.

摘要

背景

泰勒空间框架（TSF）已广泛用于胫骨骨折。然而，传统的影像学测量方法较为复杂，且复位准确性受多种因素影响。本研究旨在提出一种新的标记三维（3D）测量方法，并确定在 TSF 治疗中，标记 3D 测量方法与传统影像学测量方法在复位结果上是否存在差异。

方法

回顾性分析 2016 年 1 月至 2019 年 6 月我院采用 TSF 治疗的 41 例胫骨骨折患者的临床资料，其中标记 3D 测量组（实验组）21 例，传统影像学测量组（对照组）20 例。实验组通过在 TSF 上安装 6 个标记物进行 3D 重建，以确定电子处方。对照组行前后位（AP）和侧位 X 线片进行传统参数测量。根据复位后 AP 和侧位 X 线片评估冠状面和矢状面的残余位移畸形（RDD）和残余角度畸形（RAD），评估疗效。

结果

所有患者均获得功能复位。实验组 AP 位残余 RDD 为 0.5（0，1.72）mm，对照组为 1.74（0.43，3.67）mm。实验组 AP 位残余 RAD 为 0（0，1.25）°，对照组为 1.25（0.62，1.95）°。侧位 X 线片上，实验组 RDD 为 0（0，1.22）mm，对照组为 2.02（0，3.74）mm，实验组 RAD 为 0（0，0）°，对照组为 1.42（0，1.93）°。两组间上述各项比较差异均有统计学意义（AP 位 RDD：P=0.024，RAD：P=0.020；侧位 RDD：P=0.016，RAD：P=0.004）。