虚拟复位内固定在复杂踝关节骨折手术中的应用研究  

Application of Virtual Reduction and Internal Fixation in the Operation of Complex Ankle Joint Fractures

作　　者：魏小华 陈文锋 刘雄 刘德俊 WEI Xiaohua;CHEN Wenfeng;LIU Xiong;LIU Dejun(Department of Traumatology and Orthopedics,Orthopedic Hospital,Dongguan Eighth People's Hospital,Dongguan,Guangdong Province,523325 China;Department of Radiology,Dongguan Eighth People's Hospital,Dongguan,Guangdong Province,523325 China)

机构地区：[1]东莞市第八人民医院骨科医院创伤骨科,广东东莞523325 [2]东莞市第八人民医院放射科,广东东莞523325

出　　处：《中外医疗》2022年第7期17-21,共5页China & Foreign Medical Treatment

基　　金：东莞市社会科技发展项目资助(202050715028325)。

摘　　要：目的研究虚拟复位内固定在复杂踝关节骨折手术中的应用效果。方法方便选取2018年1月—2020年3月于东莞市第八人民医院骨科医院诊断为复杂踝关节骨折(含Pilon骨折)且需要手术行切开复位内固定患者56例,按随机数表法随机分成研究组和对照组。研究组患者术前采用数字化技术重建骨折处并进行虚拟复位内固定,对照组根据患者临床表现及X线CT检查结果确定手术方式。所有患者行踝关节骨折切开复位内固定术,比较两组患者手术时间、骨折复位质量(Burwell-Charnley影像学评分标准)、术后切口软组织并发症情况及术后恢复情况。结果所有患者都获得至少半年的随访。研究组手术时间(86.3±6.0)min低于对照组手术时间(90.0±6.1)min,差异有统计学意义(t=2.288,P=0.030);研究组术后骨折复位质量良好例数26例,复位质量可2例,对照组复位质量良好20例,复位质量可2例,欠佳6例,两组复位质量优良率差异有统计学意义(P<0.05);在切口并发症发生方面,研究组2例患者出现切口处皮肤发红,后经换药后全部一期愈合,对照组3例出现皮肤发红,3例出现切口周围发红+渗出,经换药后延期愈合,2例出现周围皮肤组织坏死,后经负压吸引后切口愈合,对照组皮肤软组织并发症高于研究组,差异有统计学意义(P<0.05);术后半年随访两组患者AOFAS足踝功能评分差异无统计学意义(P>0.05)。结论踝关节骨折术前应用数字化重建技术进行虚拟规划在提高骨折复位质量的同时可缩短手术时间,降低切口软组织并发症的发生,在提高了踝关节骨折的复位质量同时增加了手术的安全性。Objective To study the effect of virtual reduction and internal fixation in the operation of complex ankle fractures.Methods A total of 56 patients who were diagnosed with complex ankle fractures(including Pilon fractures)and required open reduction and internal fixation at the Orthopedic Hospital of the Eighth People's Hospital of Dongguan from January 2018 to March 2020 were conveniently selected.According to the random number table method,they were randomly divided into study group and control group.The patients in the study group used digital technology to reconstruct the fracture and performed virtual reduction and internal fixation.The control group determined the operation method based on the patient's clinical manifestations and X-ray CT examination results.All patients underwent open reduction and internal fixation for ankle fractures.The operation time,fracture reduction quality(Burwell-Charnley imaging scoring standard),postoperative incision soft tissue complications and postoperative recovery were compared between the two groups.Results All patients were followed up for at least half a year.The operation time in the study group(86.3±6.0)min was lower than the operation time in the control group(90.0±6.1)min.the difference was statistically significant(t=2.288,P=0.030);in the study group,there were 26 cases of good fracture reduction quality,2 cases of fair reduction quality,20 cases of good reduction quality,2 cases of fair reduction quality,and 6 cases of poor reduction quality in the control group,there was a statistically significant difference in the rate of reduction quality between the two groups(P<0.05);in terms of incision complications,2 patients in the study group had skin redness at the incision,and all healed after dressing change,3 cases had skin redness in the control group,and 3 cases had redness+exudation around the incision.Healing was delayed after dressing change,and necrosis of surrounding skin tissue occurred in 2 cases,and the incision healed after suction by negative pressure

关 键 词：踝关节骨折 数字化重建技术 虚拟复位内固定 

分 类 号：R68[医药卫生—骨科学]