创伤性胫骨平台复杂骨折利用CT模拟指导手术方法及优势探析

ARTICLE ABOUT CT SIMULATION-GUIDED SURGERY FOR TRAUMATIC TIBIAL PLATEAU COMPLEX FRACTURES AND ITS ADVANTAGES

目的探讨复杂胫骨平台创伤性骨折患者术前CT扫描三维重建模拟指导手术操作的方法及其优势。方法选取该院2016年4月—2019年2月实施手术治疗的96例复杂胫骨平台创伤性骨折患者作为研究对象进行回顾性分析,根据患者意愿分为模拟组46例(术前CT扫描三维重建模拟指导手术操作)和常规组50例(常规手术操作);比较二组的手术操作过程指标、术后住院及其康复指标、术后膝关节活动能力及膝关节功能评价及手术并发症。结果模拟组患者的手术时间、手术出血量、术中透视时间均低于常规组(均P<0.05);模拟组和常规组患者的住院时间、骨折愈合时间差异均无统计学意义(均P>0.05);在术后3个月,模拟组患者的屈膝最大角度高于常规组,差异均有统计学意义(均P<0.05);在术后3个月,模拟组患者的膝关节功能优于常规组,差异均有统计学意义(均P<0.05);术后观察,模拟组患者的的并发症率4.35%与常规组的16.00%比较,差异无统计学意义(均P>0.05)。结论复杂胫骨平台创伤性骨折患者术前CT扫描三维重建模拟指导手术操作有利于手术操作的顺利进行,减小了手术时间及出血量,对于术后患者膝关节功能的早期康复具有更好的效果。

Objective To explore the methods and advantages of 3 D reconstruction and CT-guided surgery for patients with traumatic fracture of complex tibial plateau before operation.Methods A total of ninety six patients with complex tibial plateau traumatic fractures planned to undergo surgical treatment in our hospital from April 2016 to February 2019 were selected as the research objects,and 46 cases were divided into simulation groups according to the wishes of the patients(preoperative CT scan 3 D reconstruction simulation to guide the operation)50 cases in the conventional group(conventional surgery);Compare the surgical process indicators,postoperative hospitalization and rehabilitation indicators,knee joint mobility and knee function evaluation and surgical complications between the two groups.Results The operation time,bleeding volume and intraoperative fluoroscopy time of the patients in the simulation group were all lower than those in the conventional group(P<0.05);there was no significant difference in the hospitalization time and fracture healing time between the patients in the simulation group and the conventional group(P>0.05);At 3 months after surgery,the knee flexion angle of the patients in the simulation group was higher than that in the conventional group,and the difference was statistically significant(P<0.05).At 3 months,the knee function of the patients in the simulation group was better than that of the conventional group.It was statistically significant(P<0.05);the postoperative observation showed that the complication rate of patients in the simulation group was 4.35%compared with 16.00%in the conventional group,and the difference was not statistically significant(P>0.05).Conclusion Preoperative CT scan and 3 D reconstruction of patients with complicated tibial plateau traumatic fractures can be used to guide the operation smoothly,reduce the operation time and the amount of bleeding,and have a better effect on the early rehabilitation of knee function of patients after operation.