数字化技术在复杂胫骨平台骨折诊疗中的应用研究

Application of digital technology in the diagnosis and treatment of complex tibial plateau fractures

目的探讨数字化技术在复杂胫骨平台骨折诊疗中的应用价值。方法选取2020年11月至2021年11月新疆喀什地区第一人民医院收治的80例复杂胫骨平台骨折患者,采用随机数字表法分为对照组(40例,根据CT和X线检查结果制定手术方案)和观察组(40例,采用数字化技术规划手术方案)。比较两组患者的手术时间、术中出血量、复位固定时间、骨折愈合时间,术后第3天采用影像学Rasmussen评分评估骨折复位效果,术前及术后6个月采用美国特种外科医院(Hospital for Special Surgery,HSS)膝关节临床功能评分评估患者的膝关节功能。结果观察组手术时间、复位固定时间短于对照组,术中出血量少于对照组,差异均有显著性(P<0.05),而两组骨折愈合时间比较差异无显著性(P>0.05)。术后第3天Rasmussen评分显示观察组骨折复位优良率(85.0%)明显高于对照组(62.5%),差异有显著性(P<0.05)。术前两组HSS评分比较差异无显著性(P>0.05);术后6个月两组HSS评分均明显高于术前,且观察组明显高于对照组,差异有显著性(P<0.05)。结论在复杂胫骨平台骨折的手术治疗中应用数字化技术可缩短手术及复位固定时间,减少术中出血量,提高骨折复位效果,有利于膝关节功能的恢复。

Objective Discuss the application of digital technology in the diagnosis and treatment of complex tibial plateau fractures,and provide references for the treatment of patients with complex tibial plateau fractures.Method Eighty patients with complex tibial plateau fractures admitted to our hospital from November 2020 to November 2021 were selected as the research objects.According to the time of admission,they were randomly divided into a control group(40 cases,using conventional surgery)and an experimental group(40 cases,performing operations according to digital planning).The operation time,intraoperative blood loss,reduction and fixation time,and fracture healing time were compared between the two groups.The imaging Rasmussen score was used to evaluate the effect of fracture reduction on the 3rd day after surgery.Before and 6 months after the operation,the knee joint clinical function score of the American Hospital for Special Surgery(HSS)was used to evaluate the knee joint function of the patient.Result The operation time and reduction and fixation time of the experimental group were shorter than those of the control group(P<0.05),the intraoperative blood loss was less than that of the control group(P<0.05),and the fracture healing time was not different from that of the control group(P>0.05).The excellent and good rate of fracture reduction in the experimental group was higher than that in the control group(P<0.05).There was no difference in HSS scores between the two groups before surgery(P>0.05).At 6 months after surgery,the HSS scores of the two groups were higher than those before surgery(P<0.05),and the experimental group was higher than the control group(P<0.05).Conclusion The application of digital technology in the surgical treatment of complex tibial plateau fractures can shorten the operation and reduction and fixation time,reduce intraoperative blood loss,improve the effect of fracture reduction,and benefit the recovery of knee joint function.