实体镜像对比技术、虚拟软件模拟技术在sandersⅢ、Ⅳ型跟骨骨折术前规划中的应用

CLINICAL VALUE OF SOLID IMAGE CONTRAST TECHNOLOGY AND VIRTUAL SOFTWARE SIMULA-TION TECHNOLOGY IN PREOPERATIVE PLANNING OF SANDERS TYPE Ⅲ AND Ⅳ CALCANEAL FRACTURES

目的比较研究实体镜像对比技术、虚拟软件模拟技术在sandersⅢ、Ⅳ型跟骨骨折术前规划中应用的临床价值。方法回顾性分析2018年1月—2022月2月承德医学院附属医院收治的65例复杂性跟骨骨折,依据术前规划的方式,分为实体技术组(即实体镜像对比技术组,31例),虚拟技术组(即虚拟软件模拟技术组,34例),对二组术前基础资料、围手术期指标、随访相关评价指标等予以对比研究。结果手术前一般情况的各项临床指标二组比较差异均无统计学意义(P>0.05),可进行比较研究;手术前实体技术组实施的患侧、健侧校验数据比较差异均无统计学意义(P>0.05),可实施镜像对比技术进行术前规划;总手术时间、总出血量、术中透视次数二组比较差异均无统计学意义(P>0.05);术前规划费用、术前规划时间,实体技术组多(长)于虚拟技术组(P<0.05);术前、术后3个月的Bohler角、Gissnae角及距下关节水平角二组间比较差异均无统计学意义(P>0.05),二组术前的Bohler角、Gissnae角及距下关节水平角,与其对应组别,在术后3个月的数值比较差异有统计学意义(P<0.05);患者均获得随访,随访12~18个月,AOFAS评分、ROM度数、骨折愈合优可率、跟骨长度、跟骨宽度、跟骨高度二组比较差异均无统计学意义(P>0.05)。结论实体镜像对比技术、虚拟软件模拟技术均可以为治疗sandersⅢ、Ⅳ型跟骨骨折提供了良好的术前规划,临床中需要将两种技术结合应用,提高治疗效果,但实体镜像对比技术会增加患者费用及术前准备时间。

Objective To compare and study the clinical value of solid image contrast technology and virtual software simulation technology in the preoperative planning of Sanders type II and IV calcaneal fractures.MethodsA retrospective analysis of sixty-five cases of complex calcaneal fractures admitted to the Affiliated Hospital of Chengde Medical College from January 2018 to February 2022 was conducted.According to the method of preoperative planning,they were divided into a physical technology group(a physical image comparison technology group,31 cases)and a virtual technology group(a virtual software simulation technology group,34 cases).A comparative study was conducted on the preoperative basic data,perioperative indicators,and fllow-up related evaluation indicators of the two groups.ResultsThere was no statistically significant difference in various clinical indicators of general conditions before surgery between the two groups(P>0.05),which could be compared for study;There was no statistically significant difference between the diseased side and the healthy side calibration data implemented by the preoperative entity technology group(P>O.05),and image comparison technology can be implemented for preoperative planning;There was no significant difference in total operative time,total bleeding,and intraoperative fluoroscopy frequency between the two groups(P>0.05);The cost and time of preoperative planning in the physical technology group were more(longer)than in the virtual technology group(P<0.05);There was no statistically significant difference in the preoperative Bohler angle,Gissnae angle,and subtalar joint horizontal angle between the two groups before operation and 3 months after surgery(P>0.05).The preoperative Bohler angle,Gissnae angle,and subtalar joint horizontal angle between the two groups and their corresponding groups had a statistically significant difference in the values at 3 months after surgery(P<0.05);All patients were followed up for 12 to 18 months.There was no statistically significant difference between the two groups in terms of AOFAS score,ROM degree,fracture healing success rate,calcaneal length,calcaneal width,and calcaneal height(P>0.05).Conclusion Both solid image contrast technology and virtual software simulation technology can provide a good preoperative planning for the treatment of Sanders type IIl and IV calcaneal fractures.In clinical practice,it is necessary to combine the two technologies to improve the treatment effect,but solid image contrast technology will increase patient costs and preoperative preparation time.