Li Jiaqi, Chen Hua, Zhang Wei, Qi Hongzhe, Zhu Zhengguo, Chang Zuhao, Qi Lin, Zhou Feng, Liu Haoyang, Tang Peifu
Chinese PLA General Medical School, Beijing, 100853, P. R. China.
Department of Orthopaedic Trauma, Chinese PLA General Hospital, Beijing, 100048, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Feb 15;37(2):129-135. doi: 10.7507/1002-1892.202210073.
To compare the reduction qualities of three-dimensional visible technique without fluoroscopy and two-dimensional fluoroscopy for unstable pelvic fractures during operations.
The clinical data of 40 patients with unstable pelvic fractures, who met the selection criteria in three clinical centers between June 2021 and September 2022, were retrospectively analyzed. According to the reduction methods, the patients were divided into two groups. Twenty patients in trial group were treated with unlocking closed reduction system combined with three-dimensional visible technique without fluoroscopy; 20 patients in control group with unlocking closed reduction system under two-dimensional fluoroscopy. There was no significant difference in the gender, age, injury mechanism, Tile type of fracture, Injury Severity Score (ISS), and the time between injury to operation between the two groups ( >0.05). The qualities of fracture reduction according to the Matta criteria, operative time, intraoperative blood loss, fracture reduction time, times of fluoroscopy, and System Usability Scale (SUS) score were recorded and compared.
All operations were successfully completed in both groups. According to the Matta criteria, the qualities of fracture reduction were rated as excellent in 19 patients (95%) in trial group, which was better than that in the control group (13 cases, 65%), with a significant difference ( =3.906, =0.048). The operative time and intraoperative blood loss had no significant differences between the two groups ( >0.05). The fracture reduction time and times of fluoroscopy were significantly less in trial group than in control group ( <0.05), and SUS score in trial group was significantly higher in trial group than in control group ( <0.05).
Compared to using unlocking closed reduction system under two-dimensional fluoroscopy, three-dimensional visible technique without fluoroscopy can significantly improve the reduction quality of unstable pelvic fractures without prolonging the operative time, and is valuable to reduce iatrogenic radiation exposure for patients and medical workers.
比较三维可视化技术在无透视下与二维透视下用于不稳定骨盆骨折手术时的复位质量。
回顾性分析2021年6月至2022年9月在三个临床中心符合入选标准的40例不稳定骨盆骨折患者的临床资料。根据复位方法将患者分为两组。试验组20例患者采用解锁闭合复位系统结合无透视三维可视化技术治疗;对照组20例患者采用二维透视下解锁闭合复位系统治疗。两组患者在性别、年龄、损伤机制、Tile骨折类型、损伤严重程度评分(ISS)以及受伤至手术时间方面差异均无统计学意义(P>0.05)。记录并比较根据Matta标准的骨折复位质量、手术时间、术中出血量、骨折复位时间、透视次数以及系统可用性量表(SUS)评分。
两组手术均顺利完成。根据Matta标准,试验组19例患者(95%)骨折复位质量评为优,优于对照组(13例,65%),差异有统计学意义(χ²=3.906,P=0.048)。两组手术时间和术中出血量差异无统计学意义(P>0.05)。试验组骨折复位时间和透视次数明显少于对照组(P<0.05),试验组SUS评分明显高于对照组(P<0.05)。
与二维透视下使用解锁闭合复位系统相比,无透视三维可视化技术可显著提高不稳定骨盆骨折的复位质量,且不延长手术时间,对于减少患者和医护人员的医源性辐射暴露具有重要价值。