肱骨远端骨折患者三维重建模拟对手术操作及上肢功能恢复的影响

EFFECTS OF 3D RECONSTRUCTION SIMULATION OF PATIENTS WITH COMPLEX FRACTURE OF DISTAL HUMERUS ON SURGICAL OPERATION AND FUNCTIONAL RECOVERY OF UPPER LIMBS

目的探讨肱骨远端骨折患者采用三维重建模拟手术操作对治疗效果的影响。方法选取南充市中医医院拟实施手术治疗的114例肱骨远端C型骨折患者作为研究对象,采用随机数字表法分为观察组(术前X线三维重建模拟手术操作)和对照组(传统切开复位内固定手术),各57例;比较二组的手术时间、出血量、术中透视次数、住院时间、骨折愈合时间,术后患者肘关节Mayo功能评价及肘关节的活动功能。结果观察组的手术时间、出血量、术中透视次数均低于对照组(均P<0.05);观察组的住院时间、骨折愈合时间与对照组差异均无统计学意义(均P>0.05);术后3个月,观察组的肘关节的屈曲、旋前、旋后、Baumann角均大于对照组(均P<0.05);观察组肘关节的背伸、提携角与对照组差异均无统计学意义(均P>0.05);术后3个月,观察组肘关节Mayo功能评分高于对照组(P<0.05);术后6个月,观察组肘关节Mayo功能评分与对照组差异无统计学意义(P>0.05);观察组的术后并发症发生率与对照组差异无统计学意义(P>0.05)。结论相较于传统手术,三维重建模拟手术操作在肱骨远端C型骨折患者治疗中可缩短手术时间、减少出血量及X线照射次数,对术后患者早期的肘关节活动及功能恢复方面具有一定的优势。

Objective To investigate the effect of 3 D reconstruction simulation surgery on the treatment effect of patients with complicated fracture of distal humerus.Methods One hundred and fourteen patients with type C fractures of the distal humerus who were planned to undergo surgery in Nanchong Traditional Chinese Medicine Hospital were selected as the research objects.Random number tables were used to divide into the test group(preoperative X-ray 3 D reconstruction to simulate surgical operation and the control group(native reduction and internal fixation surgery);the operation time,bleeding volume,number of intraoperative fluoroscopy,length of hospital stay,and fracture healing time were compared between the two groups.Results The operation time,bleeding volume,and number of intraoperative fluoroscopy in the experimental group were lower than those in the control group(P<0.05);the hospital stay,fracture healing time in the experimental group were not significantly different from those in the control group(P>0.05);At one month,the flexion,pronation,supination,and Baumann angle of the elbow joint in the test group were greater than those in the control group(P<0.05);there was no significant difference in the dorsal extension and carrying angle of theelbow joint between the test group and the control group(P>0.05).);3 months after operation,the Mayo function score of the elbow joint in the test group was higher than the control group(P<0.05);6 months after operation,the Mayo function score of the elbow joint in the test group was not significantly different from the control group(P>0.05);postoperative statistics,there was no significant difference in the complication rate between the experimental group and the control group(P>0.05).Conclusion Compared with traditional surgery,the 3 D reconstruction simulation operation can shorten the operation time,reduce the amount of bleeding and the number of X-rays in the treatment of patients with type C fractures of the distal humerus,and has certain advantages in early elbow movement and functional recovery.