Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, 410011, China.
Department of Infectious Disease, the Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, 161 Southern Shaoshan Road, Changsha, 410004, China.
BMC Musculoskelet Disord. 2022 Mar 28;23(1):295. doi: 10.1186/s12891-022-05219-7.
To assess the preoperative planning of visualized simulative surgery (VSS) and clinical outcomes based on computer-aided design (CAD) and 3D reconstruction for proximal femoral varus osteotomy of DDH.
A total of 31 consecutive patients (23 females and 8 males) with DDH who underwent proximal femoral varus osteotomy were retrospectively reviewed between June 2014 and July 2018. Patients were divided into conventional group (n = 15) and VSS group (n = 16) according to different surgical methods. In VSS group, 16 consecutive patients who underwent proximal femoral varus osteotomy were evaluated preoperatively with the aid of VSS. The VSS steps included morphological evaluation of DDH, simulated reconstruction of proximal femoral varus osteotomy, and the implantation of locking compression pediatric hip plate (LCP-PHP). Meanwhile, the osteotomy degrees, surgery time, and radiation exposure were compared between the two groups.
The average follow-up time was 33.5 months (range, 24 to 46 months). The varus angle for proximal femoral varus osteotomy was 24.2 ± 1.1° in VSS group and 25.1 ± 1.0° in conventional group (P = 0.4974). The surgery time was 31.0 ± 4.5 mins in VSS group and 48.2 ± 7.3 mins in conventional group, while radiography was 5.0 ± 1.5 times in VSS group and 8.3 ± 2.4 times in conventional group. There was a statistical significance in surgery time and radiography (P < 0.0001) when compared with the conventional group.
The VSS can greatly decrease surgery time and radiation exposure for proximal femoral varus osteotomy, which could also be a tool to train young doctors to improve surgical skills and academic communication.
评估基于计算机辅助设计（CAD）和 3D 重建的可视化模拟手术（VSS）在发育性髋关节发育不良（DDH）股骨近端内翻截骨术的术前规划和临床效果。
回顾性分析 2014 年 6 月至 2018 年 7 月收治的 31 例（女 23 例，男 8 例）DDH 患者，均接受股骨近端内翻截骨术，根据手术方法不同分为常规组（n=15）和 VSS 组（n=16）。VSS 组 16 例行股骨近端内翻截骨术患者术前借助 VSS 评估，VSS 步骤包括 DDH 形态学评估、模拟股骨近端内翻截骨重建、锁定加压儿童髋钢板（LCP-PHP）植入。比较两组患者截骨角度、手术时间、射线暴露量。
平均随访时间 33.5 个月（24~46 个月）。VSS 组股骨近端内翻截骨角度为 24.2°±1.1°，常规组为 25.1°±1.0°（P=0.4974）。VSS 组手术时间为 31.0±4.5 min，常规组为 48.2±7.3 min，VSS 组射线暴露量为 5.0±1.5 次，常规组为 8.3±2.4 次。与常规组比较，VSS 组手术时间、射线暴露量差异均有统计学意义（P<0.0001）。
VSS 可明显减少股骨近端内翻截骨术的手术时间和射线暴露量，是培训年轻医生、提高手术技能和学术交流的工具。
