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计算机虚拟技术联合骨盆复位架治疗C型骨盆骨折的疗效

[Effect of computer virtual technique combined with pelvic reduction frame in the treatment of type C pelvic fracture].

作者信息

Huang Chen, Zheng Wei, Ren Ya-Ming, Deng Shao-Lin, Liao Dong-Fa

机构信息

Department of Orthopaedics, General Hospital of Western Theater Command, Chengdu 610083, Sichuan, China.

出版信息

Zhongguo Gu Shang. 2022 Apr 25;35(4):323-8. doi: 10.12200/j.issn.1003-0034.2022.04.004.

Abstract

OBJECTIVE

To investigate the short-term clinical effect of the computer virtual technique combined with pelvic reduction frame in the treatment of complex pelvic fractures.

METHODS

Thirty patients with Tile C pelvic fractures treated by percutaneous minimally invasive pelvic reduction frame from April 2018 to April 2020 were retrospectively analyzed, including 21 males and 9 females, aged from 19 to 57 (39.40±9.85) years old. The patient's pelvic CT DICOM data were imported into Mimics software to reconstruct the virtual fracture model. Virtual reduction and nail placement were carried out on the fracture model, and then simulated fluoroscopy was carried out to record the ideal fluoroscopy orientation and angle to guide the correct fluoroscopy during operation. The operation time, fluoroscopy times and intraoperative blood loss were recorded. The quality of fracture reduction was evaluated by Matta image score standard, and the postoperative function was evaluated by Majeed function score standard.

RESULTS

All 30 patients achieved closed reduction and percutaneous screw fixation. According to Matta score, the excellent and good rate of fracture reduction was 93.3%(28/30). A total of 67 channel screws were inserted, and the excellent and good rate was 98.5%(66/67). The operation time was (173.54±79.31) min, fluoroscopy time was (90.81±41.11) times, intraoperative blood loss was (81.21±43.97) ml. All incisions healed at one stage without broken nails or re-displacement of fractures. All patients were followed up for 12 months. At the final follow-up, Majeed function score was 73 to 94(85.66±5.33) scores.

CONCLUSION

Computer virtual technology combined with pelvic reduction frame could rapidly, accurately and safely reduce and fix unstable pelvic fractures. Computer virtualization could help surgeons to recognition and understanding pelvic fractures, pelvic reduction frame could improve the surgeon's ability to manage complex and unstable pelvic injuries.

摘要

目的

探讨计算机虚拟技术联合骨盆复位架治疗复杂骨盆骨折的短期临床疗效。

方法

回顾性分析2018年4月至2020年4月采用经皮微创骨盆复位架治疗的30例Tile C型骨盆骨折患者,其中男性21例,女性9例,年龄19~57岁,平均(39.40±9.85)岁。将患者骨盆CT DICOM数据导入Mimics软件重建虚拟骨折模型,在骨折模型上进行虚拟复位和置钉,然后进行模拟透视,记录理想的透视方位和角度,以指导术中正确透视。记录手术时间、透视次数及术中出血量。采用Matta影像评分标准评价骨折复位质量,采用Majeed功能评分标准评价术后功能。

结果

30例患者均实现闭合复位及经皮螺钉固定。按Matta评分,骨折复位优良率为93.3%(28/30)。共置入67枚通道螺钉,优良率为98.5%(66/67)。手术时间为(173.54±79.31)min,透视次数为(90.81±41.11)次,术中出血量为(81.21±43.97)ml。所有切口均一期愈合,无断钉及骨折再移位。所有患者均随访12个月,末次随访时Majeed功能评分为73~94分,平均(85.66±5.33)分。

结论

计算机虚拟技术联合骨盆复位架能快速、准确、安全地复位和固定不稳定骨盆骨折。计算机虚拟化有助于术者认识和理解骨盆骨折,骨盆复位架可提高术者处理复杂不稳定骨盆损伤的能力。

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