计算机三维仿真技术与常规手术治疗胫骨平台骨折的疗效对比分析

Computer Aid Designed Operation of Tibial Plateau Fracture by 3D Simulation Technique

目的探讨应用计算机三维仿真技术治疗胫骨平台骨折的疗效。方法应用计算机-快速成形技术治疗胫骨平台骨折73例(计算机辅助组),术前采取CT三维重建、计算机模拟、快速成型与个体化标本预手术;采用常规手术方法治疗62例(常规手术组)。两组病例记录手术时间和出血量,术后均采用Merchant评分评定膝关节功能。结果随访6～34个月,平均17个月。计算机辅助组获得随访52例,优31例,良16例,可3例,差2例,优良率90.4%。常规手术组获得随访47例,优20例,良19例,可6例,差3例,优良率83.0%。与常规手术组比较,计算机辅助组术中出血量少,手术时间短,差异有统计学意义(P<0.01),术后功能评分优良率高。结论计算机-快速成形技术有助于术前个体化手术方案的设计,并能提高胫骨平台骨折手术效率与精确度。

Objective To precisely treat tibial plateau fracture by 3d simulation through computer aid designed operation and compare with simple operation. Methods The CT images of tibial plateau fracture of 73 patients were imputed into computer for 3D reconstruction, then the operation were done under C-arm fluoroscopy.Sixty-two patients were treated through conventional operation.Bleeding volume and time were recorded in operation. Kness function were assessed by Merchant scores after operation in two groups.Results Fiftytwo patients were in computer-aided group and 47 patients in no computer-aided group.Thirty-one patients were excellent, 16 were good, 3 were middle and 2 were bad, and the excel.lent and good rate was 90.4% in computer-aided group.Compared with no computeraided group, bleeding volume was less and the operation time was shorter in the computer-aided groupand the difference was statistically significant.Conclusion Computer aid designed operation of tibial plateau fracture by 3D simulation technique can be helpful in designing operation schedule individually. And it is capable of increasing efficiency and accuracy in operation.