胫骨平台骨折重建过程中64层CT的定位导航方法

Navigation method of 64-slice CT reconstruction in tibial plateau fractures

背景:64层CT重建技术在胫骨平台骨折中得到应用且效果理想,该技术能够立体的、多方位的重建骨折的三维空间关系,为医师治疗提供更加科学的定位导航标准,提高临床治愈率。但临床上对于64层CT重建技术在胫骨平台骨折中的定位导航方法缺乏统一标准。目的:研究胫骨平台骨折中64层CT重建的定位导航方法及效果。方法:纳入44例胫骨平台骨折患者,其中男27例,女17例,年龄21-74岁,随机分为2组,每组22例,对照组依据医师经验进行定位导航固定治疗,试验组依据64层CT重建结果进行定位导航固定治疗。比较两组两组骨折愈合时间、完全负重时间、治疗后1年膝关节活动度、治疗后1年膝关节功能恢复及不良反应情况。结果与结论:1两组完全负重时间、治疗后1年膝关节活动度比较差异无显著性意义(P>0.05),试验组骨折愈合时间显著短于对照组(P<0.05);2试验组治疗后1年膝关节功能优良率为100%,显著高于对照组的81%(P<0.05);3试验组治疗后并发症发生率为8%,显著低于对照组的18%(P<0.05);4结果表明:64层CT重建在胫骨平台骨折定位导航中效果理想,能够清晰模拟置钉内固定通道,清晰显示胫骨平台骨折解剖形态学特点,提高内固定技术精度,提高修复效果。

BACKGROUND：64-slice CT reconstruction technique for tibial plateau fractures has obtained satisfactory results.This technology can reconstruct three-dimensional fracture relations,provide more scientific positioning and navigation standards for physicians,and improve the clinical cure rate.However,in the clinic,navigation method of 64-slice CT reconstruction techniques for tibial plateau fractures lacks a unified standard.OBJECTIVE：To study the navigation method and effect of 64-slice CT reconstruction in tibial plateau fractures.METHODS：A total of 44 patients with tibial plateau fractures were enrolled in this study,including 27 males and 17 females,at the age between 21 and 74 years old.These patients were randomly divided into two groups（n=22）.The control group underwent navigation method according to physician＇s experience.The test group underwent navigation method according to 64-slice spiral CT scan results.Healing time,full weight-bearing time,knee motion range at 1 year postoperatively,the recovery of knee function at 1 year postoperatively and adverse reaction were compared between the two groups.RESULTS AND CONCLUSION：（1） No significant differences in full weight-bearing time and knee motion range at 1 year postoperatively were detected between the two groups（P〈 0.05）.Healing time was significantly shorter in the test group than in the control group（P〈 0.05）.（2） The excellent and good rate of knee joint was 100% at 1 year postoperatively in the test group,which was significantly higher than the control group（81%）（P〈 0.05）.（3） The complication rate was significantly lower in the test group（8%） than in the control group（18%）（P〈 0.05）.（4） These results indicate that the effect of 64-slice CT reconstruction for navigation in tibial plateau fractures was ideal,could clearly simulate the pedicle screw fixation channel,visibly display anatomic characteristics of tibial plateau fractures,improve internal fixation accuracy,and improve repair effect.