多层螺旋CT三维重建技术在肘关节恐怖三联征尺骨鹰嘴截骨入路手术中的应用

Application of Multi-slice Spiral CT 3D Reconstruction Technique in Olecranon Osteotomy Approach for Terrible Triad Injury of the Elbow

目的:探究多层螺旋CT(MSCT)三维重建技术在肘关节恐怖三联征尺骨鹰嘴截骨入路手术中的应用。方法:选取2020年3月-2022年2月中信惠州医院骨外科收治的82例肘关节恐怖三联征患者为研究对象,采用随机数字表法将患者分为A组(n=41)和B组(n=41)。A组联合MSCT三维重建技术行尺骨鹰嘴截骨入路手术,B组在肘关节正侧位X线、CT检查下行肘关节内外侧联合入路手术,比较两组手术疗效、肘关节功能、生活质量、疼痛状况、并发症发生率。结果:A组患者优良率明显优于B组,差异有统计学意义(P<0.05)。A组的SF-36量表的精神健康、情感职能、总体健康评分虽均高于B组,但组间比较差异均无统计学意义(P>0.05),A组的SF-36量表的其余维度得分均高于B组,差异均有统计学意义(P<0.05)。术后1、3个月,A组的VAS评分均明显低于B组,差异均有统计学意义(P<0.05)。术后6个月,A组的Mayo肘关节功能评分明显高于B组,差异有统计学意义(P<0.05)。A组的并发症发生率明显低于B组(P<0.05)。结论:MSCT三维重建技术通过尺骨鹰嘴截骨入路对肘关节恐怖三联征疗效明显,可减轻患者术后疼痛,并有效促进肘关节功能康复,降低疾病对生活质量造成的不良影响,提高患者生活质量。

Objective: To explore the application of multi-slice spiral CT 3D reconstruction technique in the operation of terrible triad injury of the elbow with olecranon osteotomy approach. Method: From March 2020 to February 2022, 82 patients with terror triad of the elbow admitted to the Department of Orthopedics, Citic Huizhou Hospital were selected as the research objects. The patients were divided into group A(n=41) and group B(n=41)by random number table method. Ulna olecranon osteotomy was performed in group A combined with multi-slice spiral CT 3D reconstruction technique, in group B, the combined medial and lateral approach of the elbow joint was performed under anteroposidal X-ray and CT examination. The surgical efficacy, elbow joint function, quality of life,pain status and incidence of complications were compared between the two groups. Result: The excellent and good rate of group A was significantly better than group B, the difference was statistically significant(P<0.05). The mental health, emotional function and overall health scores of the SF-36 scale of group A were higher than those of group B,but there were no statistical differences between groups(P>0.05);the scores of other dimensions of the SF-36scale of group A were higher than those of group B, the differences were statistically significant(P<0.05). 1 month and 3 months after surgery, VAS scores in group A were significantly lower than those in group B, the differences were statistically significant(P<0.05). 6 months after surgery, the Mayo elbow joint function score in group A was significantly higher than that in group B, the difference was statistically significant(P<0.05). The complication rate of group A was significantly lower than that of group B(P<0.05). Conclusion: MSCT 3D reconstruction technique through the ulna olecranon osteotomy approach is effective in the treatment of elbow terror triad, which can reduce postoperative pain, effectively promote elbow functional rehabilitation, reduce the adverse impact of the disease on the quality of life, and improve the quality of life of patients.