数字骨科技术辅助切开复位内固定术治疗跟骨骨折的临床研究  

Clinical study on open reduction internal fixation assisted by digital orthopaedic technique in the treatment of calcaneal fractures

作　　者：吴青松[1] 孙鹏[1] 李立[1] 韩明涛[1] 

机构地区：[1]山东省文登整骨医院,山东文登264400

出　　处：《中医正骨》2015年第12期20-23,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:探讨数字骨科技术在跟骨骨折切开复位内固定术中的应用价值。方法:将44例符合要求的跟骨骨折患者随机分为数字技术组和传统手术组,每组22例。数字技术组术前利用Mimics 15.0软件及跟骨3D打印模型进行模拟复位和手术,确定钢板种类、位置及螺钉的位置和长度,同时对钢板进行塑形,术中按照根据模拟手术制定的手术方案进行切开复位内固定手术;传统手术组按照传统方式进行切开复位内固定术。比较2组患者的切口长度、手术时间、出血量、术中X线透视次数、住院时间及骨折复位情况。结果:数字技术组的术中X线透视次数和手术时间均少于传统手术组[(7.4±3.6)次,(10.4±2.6)次,t=3.144,P=0.003;(51.0±7.7)min,(57.8±9.6)min,t=2.580,P=0.013],2组患者的出血量、切口长度、住院时间比较,组间差异均无统计学意义[(25.4±3.8)m L,(26.6±4.3)m L,t=1.043,P=0.303;(12.4±1.3)cm,(13.0±1.2)cm,t=1.831,P=0.074;(10.5±2.3)d,(10.4±1.7)d,t=0.226,P=0.823]。按照Burwell-Charnley放射学评价标准,数字技术组解剖复位15例、复位一般3例、复位差4例,传统手术组解剖复位12例、复位一般2例、复位差8例;2组患者的复位情况比较,差异无统计学意义(Z=-1.113,P=0.266)。结论:数字骨科技术辅助下行切开复位内固定术治疗跟骨骨折,可获得较好的骨折复位,而且能减少术中X线透视次数、缩短手术时间,值得临床推广应用。Objective：To explore the applied value of digital orthopaedic technique in open reduction internal fixation （ORIF） for treat- ment of calcaneal fractures. Methods： Forty - four patients with calcaneal fracture enrolled in the study were randomly divided into digital technique group and conventional surgery group, 22 cases in each group. Simulated ORIF were performed on patients in digital technique group before the surgery by using Mimics 15.0 software and calcaneal 3D printing model to determine type and location of the steel plate and location and length of the screws, and the steel plates were reshaped. During the surgery ORIF were performed in digital technique group according to the operation plan which was formulated on the basis of simulated surgery, while conventional ORIF were performed in conventional surgery group. The incision length, operative time, blood loss, frequency of intraoperative X - ray exposure, hospital stays and fracture reduction results were compared between the 2 groups. Results： The frequency of intraoperative X - ray exposure and operative time were less in digital technique group compared to conventional surgery group（7.4 ＋/-3.6 vs 10.4 ＋/-2.6, t = 3. 144, P = 0. 003 ;51.0 ＋/- 7.7 vs 57.8 ＋/- 9.6 min ,t =2. 580 ,P = 0. 013 ）. There was no statistical difference in the blood loss, incision length and hospital stays be- tween the 2 groups （25.4 ＋/- 3.8 vs 26.6 ＋/- 4.3 ml, t = 1. 043, P = 0. 303 ; 12.4 ＋/- 1.3 vs 13.0 ＋/- 1.2 cm, t = 1.831, P = 0. 074 ; 10.5 ＋/- 2.3 vs 10.4 ＋/- 1.7 days,t = 0. 226, P = 0. 823 ）. According to Burwell - Chamley radiological evaluation standard, 15 patients obtained anatomical reduction ,3 fair and 4 poor in digital technique group; while 12 patients obtained anatomical redaction, 2 fair and 8 poor in conventional surgery group. There was no statistical difference in the fracture reduction results between the 2 groups（ Z = - 1.113, P = 0. 266）. Conclusion： In the treatment of calcaneal fractures, ORIF assisted

关 键 词：跟骨 数字骨科 3D打印 骨折固定术 内 治疗 临床研究性 

分 类 号：R687.3[医药卫生—骨科学]