肩关节骨折的数字化辅助治疗  

Digital aided treatment for shoulder joint fracture

作　　者：章莹[1] 肖进[1] 夏远军[1] 万磊[1] 吴文[1] 谢会斌[1] 尹庆水[1] 

机构地区：[1]广州军区广州总医院骨科医院创伤骨科,广东广州510010

出　　处：《临床骨科杂志》2013年第1期45-48,共4页Journal of Clinical Orthopaedics

基　　金：广东省自然科学基金团队项目(编号:20023001)

摘　　要：目的探讨计算机三维仿真技术辅助个体化肩关节骨折的治疗效果。方法选择获得随访≥6个月的90例肱骨近端骨折及30例肩胛骨骨折患者共120例,采用传统手术治疗60例,数字化辅助手术治疗60例,数字化辅助组在术前CT图像三维重建、快速成型、计算机三维模拟手术和个体化预手术的基础上实施精确化手术。比较两组术中复位固定时间及随访6个月时的肩关节功能情况。结果 120例均获随访,时间6～36(13.5±4.5)个月。数字化辅助组与传统手术组复位固定时间分别为38～42(40.3±5.4)min和47～65(53.3±5.7)min,术中出血量分别为70～100(80.3±15.9)ml和95～120(100.7±10.4)ml;两组比较差异均有统计学意义(P<0.01)。随访6个月时,肩关节功能按Neer评分:数字化辅助组优良率为86.67%,传统手术组为79.3%,两组比较差异无统计学意义(P>0.05)。结论计算机三维仿真技术辅助个体化肩关节手术可以缩短术中复位固定时间,提高肩关节骨折手术的精确度,是治疗肩关节骨折的有效方法。Objective To investigate the effect of computer aided 3D simulation technique for treating shoulder joint fracture individually.Methods 90 patients with proximal humerus fractures and 30 patients with scapula fractures were treated surgically.All of them were followed up beyond or equal six months after surgery.60 patients were treated by traditionally surgery and the others were treated by digital aided technology.The patients in digital aided group got CT images 3D reconstruction and simulation,rapid prototyping and preoperation individually before operations.Then the surgeons could operate precisely.An retrospective study were underwent to compare the time of reduction and fixation during the operations,and the function of should joints at six months(according to Neer score evaluation system).Results 120 patients were followed up for 6-36(13.5±4.5)months.The time of reduction and fixation of surgery was 38-42(40.3±5.4)min and 47-65(53.3±5.7)min in the computer aided group and the traditional surgery group respectively,and the statistically difference was significant(P<0.001).The volume of bleeding in operation was 70-100(80.3±15.9) ml in computer aided group and 95-120(100.7±10.4) ml in the traditional surgery group and the statistical difference was significant too.At 6 months follow up,the shoulder joint Neer scores of computer aided group(the excellent and good rate was 86.67%) were better than those in the traditional surgery group(79.3%).But the statistical difference was not significant(P>0.05).Conclusions Computer aided 3D simulation individualized surgery can be used effectively to reduce reduction and fixation time during the operations and improve the surgical accuracy for shoulder joint fracture.

关 键 词：肩关节骨折 数字化辅助 

分 类 号：R683.1[医药卫生—骨科学] R684.7[医药卫生—外科学] R687.3[医药卫生—临床医学] R687.4